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Hossain S, Mihrshahi S. Effect of exclusive breastfeeding and other infant and young child feeding practices on childhood morbidity outcomes: associations for infants 0-6 months in 5 South Asian countries using Demographic and Health Survey data. Int Breastfeed J 2024; 19:35. [PMID: 38755734 PMCID: PMC11097433 DOI: 10.1186/s13006-024-00644-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Accepted: 05/12/2024] [Indexed: 05/18/2024] Open
Abstract
BACKGROUND Despite growing evidence of the impacts of exclusively breastfeeding infants during the first 6 months of life on preventing childhood infections and ensuring optimal health, only a small number of studies have quantified this association in South Asia. METHODS We analyzed data from the Demographic and Health Surveys in Afghanistan (2015; n = 3462), Bangladesh (2017-2018; n = 1084), India (2019-2021; n = 26,101), Nepal (2022; n = 581), and Pakistan (2017-2018; n = 1,306), including babies aged 0-6 months. Multivariate logistic regression models were used to determine the association between exclusive breastfeeding in the last 24 h and diarrhoea, acute respiratory infections, and fever in the two weeks before the survey. We also examined the association between other infant and young feeding indicators and these outcomes. RESULTS Infants who were exclusive breastfed had decreased odds of diarrhoea in Afghanistan (AOR: 0.49, 95% CI 0.35, 0.70), India (AOR: 0.80, 95% CI 0.70, 0.91), and Nepal (AOR: 0.42, 95% CI 0.20, 0.89). Compared with infants who were not exclusive breastfed, infants who were exclusively breastfed were less likely to have fever in Afghanistan (AOR: 0.36, 95% CI 0.26, 0.50) and India (AOR: 0.75, 95% CI 0.67, 0.84). Exclusive breastfeeding was associated with lower odds of acute respiratory infections in Afghanistan (AOR: 0.57, 95% CI 0.39, 0.83). Early initiation of breastfeeding was protective against diarrhoea in India. Bottle feeding was a risk factor for diarrhoea in India and for fever in Afghanistan and India. Bottle feeding was also a risk factor for acute respiratory infection in Afghanistan and India. CONCLUSIONS Not exclusive breastfeeding is a risk factor for diarrhoea, acute respiratory infections, and fever in some South Asian countries. These findings could have substantial implications for global and national efforts to increase exclusive breastfeeding rates. More support, advocacy, and action are required to boost breastfeeding rates as a crucial public health measure.
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Affiliation(s)
- Saldana Hossain
- Department of Health Sciences, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, NSW, 2109, Australia.
| | - Seema Mihrshahi
- Department of Health Sciences, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, NSW, 2109, Australia.
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Tran LM, Nguyen PH, Young MF, Martorell R, Ramakrishnan U. The relationships between optimal infant feeding practices and child development and attained height at age 2 years and 6-7 years. MATERNAL & CHILD NUTRITION 2024:e13631. [PMID: 38450914 DOI: 10.1111/mcn.13631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 12/31/2023] [Accepted: 01/23/2024] [Indexed: 03/08/2024]
Abstract
Limited evidence exists on the long-term effects of early feeding practices on child growth and development. We examined the relationships between infant feeding practices and child height and development at ages 2 and 6-7 years. We studied 885 mother-child dyads from a randomized controlled trial of preconception supplementation in Vietnam. Early initiation of breastfeeding (EIBF), exclusive breastfeeding (EBF), breastfeeding (BF) duration and minimum dietary diversity (MDD) were assessed using World Health Organization (WHO) guidelines. Child development was assessed by the Bayley Scales of Infant Development-III at 2 years and the Wechsler Intelligence Scale for Children® - IV at 6-7 years. Child height-for-age z-score (HAZ) was calculated from child height and age. Multivariable regression and structural equation models were used in analyses that controlled for confounding. EIBF and EBF at 6 months occurred in 52% and 62% of children, respectively. Mean breastfeeding duration was 18 months and 83% achieved MDD at 1 year. EIBF was associated with motor (β = 0.13, 95% confidence interval [CI]: 0.00, 0.28) and cognitive development at 2 years (β = 0.12, 95% CI: -0.01, 0.26), which in turn were positively associated with cognitive development at 6-7 years. EBF was directly associated with development at 6-7 years (β = 0.21, 95% CI:0.08, 0.34) whereas motor and cognitive development at 2 years explained 41%-75% of the relationship between EIBF and development at 6-7 years. HAZ at 2 years also mediated 70% of the association between MDD at 1 year and HAZ at 6-7 years. BF duration was not associated with child development and HAZ. Early infant feeding practices, especially EIBF and EBF, have important long-term implications for optimizing child linear growth and cognition as they begin school.
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Affiliation(s)
- Lan Mai Tran
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
- Doctoral Program in Nutrition and Health Sciences, Laney Graduate School, Emory University, Atlanta, Georgia, USA
| | - Phuong H Nguyen
- Nutrition, Diets, and Health Unit, International Food Policy Research Institute, Washington, District of Columbia, USA
- Thai Nguyen University of Pharmacy and Medicine, Thai Nguyen, Vietnam
| | - Melissa F Young
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
- Doctoral Program in Nutrition and Health Sciences, Laney Graduate School, Emory University, Atlanta, Georgia, USA
| | - Reynaldo Martorell
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
- Doctoral Program in Nutrition and Health Sciences, Laney Graduate School, Emory University, Atlanta, Georgia, USA
| | - Usha Ramakrishnan
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
- Doctoral Program in Nutrition and Health Sciences, Laney Graduate School, Emory University, Atlanta, Georgia, USA
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Giang HTN, Hieu LTM, Duy DTT, Phuong MT, Trung TD. The effect of skin-to-skin contact on early initiation of breastfeeding among women in Vietnam. Pediatr Neonatol 2023:S1875-9572(23)00215-2. [PMID: 38057258 DOI: 10.1016/j.pedneo.2023.07.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Revised: 06/13/2023] [Accepted: 07/18/2023] [Indexed: 12/08/2023] Open
Abstract
AIM To describe prevalence of early initiation of breastfeeding and associated factors among Vietnamese mothers. METHODS A self-administered questionnaire was used to survey 1812 mothers whose infants were aged 0 to less than 30 months in multi-center Vietnam. Multivariate logistic regression was performed to identify factors associated independently with early initiation of breastfeeding. RESULTS Prevalence of early initiation of breastfeeding was 57.2 % and this prevalence was higher in female infants compared with male infants (p = 0.004). Factors associated with increased odds of early initiation of breastfeeding include female infants (aOR: 1.33; 95%CI: 1.06 to 1.68) living in urban areas (aOR: 1.34, 95%CI: 1.05 to 1.71), giving birth in private hospitals (aOR: 1.94, 95%CI: 1.25 to 3.03), vaginal birth (aOR: 1.70, 95%CI: 1.34 to 2.16). Factors associated with decreased odds of early initiation of breastfeeding include higher educational level, mother's weight gain during pregnancy, and infant complication at birth. Compared with mothers who had not experienced skin-to-skin contact with their babies, the prevalence of early initiation of breastfeeding was higher in mothers who experienced <15 min (aOR: 2.03, 95%CI: 1.32 to 3.14), 15-90 min (aOR: 6.33, 95%CI: 4.11 to 9.76), and >90 min (aOR: 10.98, 95%CI: 6.79 to 17.75). CONCLUSION Focusing on modifiable factors should be a key priority to help improve early initiation of breastfeeding practice.
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Affiliation(s)
- Hoang Thi Nam Giang
- School of Medicine and Pharmacy, The University of Danang, Danang, Viet Nam.
| | - Le Tho Minh Hieu
- School of Medicine and Pharmacy, The University of Danang, Danang, Viet Nam
| | - Do Thi Thuy Duy
- School of Medicine and Pharmacy, The University of Danang, Danang, Viet Nam
| | | | - Tran Dinh Trung
- Faculty of Public Health, Danang University of Medical Technology and Pharmacy, Danang, Viet Nam
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Khanal V. Influence of breastfeeding education and support on predominant breastfeeding: Findings from a community-based prospective cohort study in Western Nepal. Health Sci Rep 2023; 6:e1548. [PMID: 37680209 PMCID: PMC10480414 DOI: 10.1002/hsr2.1548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 08/17/2023] [Accepted: 08/22/2023] [Indexed: 09/09/2023] Open
Abstract
Background and Aims Breastfeeding education and support have the potential to improve breastfeeding outcomes. However, there is a lack of research on the impact of breastfeeding education on predominant breastfeeding in Nepal and other South Asian countries. This study aimed to report the rate of predominant breastfeeding at the first, fourth, and sixth months of birth and examine the influence of breastfeeding promotion on predominant breastfeeding. Methods A community-based prospective cohort study was conducted in western Nepal. A total of 735 mother-infant pairs were recruited within 30 days of childbirth and followed up at the fourth and sixth months to collect data on infant feeding practices. Results The rate of predominant breastfeeding at first, fourth, and sixth months were 88.6% (N = 735), 78.2% (N = 715), and 26.3% (N = 711), respectively, showing a significant decline with infant age. Mothers who received support on breastfeeding skills (Adjusted Odds Ratio [AOR]: 2.55; 95% confidence interval [CI]: 1.73-3.75), those who received advice on keeping mother-infant together (AOR: 2.19; 95% CI: 1.14-4.22) and who had initiated breastfeeding within 1 h of childbirth (AOR: 2.55; 95% CI: 1.73-3.75), and who were educated, had higher likelihood of predominant breastfeeding at sixth month. Conclusion This study asserts a need for continuous and focused breastfeeding promotion programs to educate and support lactating mothers.
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Yu Y, Liu Q, Xiong X, Luo Y, Xie W, Song W, Fu M, Yang Q, Yu G. Breastfeeding needs of mothers of preterm infants in China: a qualitative study informed by the behaviour change wheel. Int Breastfeed J 2023; 18:50. [PMID: 37658411 PMCID: PMC10472562 DOI: 10.1186/s13006-023-00587-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 08/25/2023] [Indexed: 09/03/2023] Open
Abstract
BACKGROUND Although breastfeeding is strongly recommended, the breastfeeding rate of preterm infants in China remains significantly low. In addition to the global structural challenges to breastfeeding and the physiological immaturity of preterm infants, Chinese mothers of preterm infants face unique challenges of maternal-infant separation after birth. Moreover, little is known about Chinese mothers' specific needs in coping with the difficulties posed by these challenges. This study utilized the Behaviour Change Wheel to investigate the breastfeeding needs of Chinese preterm mothers that may facilitate its practice in the future. METHOD A qualitative descriptive design was implemented in Wuhan in 2022. Based on purposeful sampling, 13 preterm mothers were recruited from a NICU in a Grade III Class A hospital in Wuhan, China. Face-to-face semi-structured interviews were conducted to collect data using the interview guide developed by the Theoretical Domains Framework. Theoretical Thematic Analysis was used to review the data in 6 steps to identify themes. RESULTS Five major themes emerged: (1) capability: ability to interpret infants' cues and identify problems, and need for breastfeeding knowledge and skills training; (2) physical opportunity: cleanliness and quietness in household environment, private lactation spaces and breastfeeding tools in workplaces and hospitals; (3) social opportunity: family support, peer support, and authoritative support from healthcare providers; (4) reflective motivation: information on health impacts of breastfeeding; (5) automatic motivation: maternal-infant bonding, free of aversive stimulus. CONCLUSION Preterm mothers' needs to enable breastfeeding were diverse, including increasing their capability, physical and social opportunities, and reflective and automatic motivation. People, resources and environments associated with these needs should be engaged together to stablish a conducive structural environment for breastfeeding. The policy change for "zero separation" and implementation of kangaroo care should also be implemented in Chinese neonatal intensive care units. Future studies are needed to design effective interventions according to mothers' specific needs.
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Affiliation(s)
- Yaqi Yu
- Nursing Department, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1095, Jiefang Avenue, Wuhan, China
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, No. 13, Aviation Road, Wuhan, China
| | - Qianru Liu
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, No. 13, Aviation Road, Wuhan, China
- Nursing Department, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1277, Jiefang Avenue, Wuhan, China
| | - Xiaoju Xiong
- Nursing Department, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1095, Jiefang Avenue, Wuhan, China
| | - Ying Luo
- Nursing Department, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1095, Jiefang Avenue, Wuhan, China
| | - Wen Xie
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, No. 13, Aviation Road, Wuhan, China
| | - Wenshuai Song
- Nursing Department, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1095, Jiefang Avenue, Wuhan, China
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, No. 13, Aviation Road, Wuhan, China
| | - Maoling Fu
- Nursing Department, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1095, Jiefang Avenue, Wuhan, China
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, No. 13, Aviation Road, Wuhan, China
| | - Qiaoyue Yang
- Nursing Department, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1095, Jiefang Avenue, Wuhan, China
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, No. 13, Aviation Road, Wuhan, China
| | - Genzhen Yu
- Nursing Department, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1095, Jiefang Avenue, Wuhan, China.
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Al-Taj MA, Al Serouri A, Al-Muradi AM, Al-Dharhani E, Al-faeq NN, Al-amodi FM, Abdulwahab MM, Nawfal AM, Alshemerry MH, Mujahed MA. Concurrent wasting and stunting among marginalised children in Sana'a city, Yemen: a cross-sectional study. J Nutr Sci 2023; 12:e91. [PMID: 37587974 PMCID: PMC10425760 DOI: 10.1017/jns.2023.72] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 05/16/2023] [Accepted: 07/10/2023] [Indexed: 08/18/2023] Open
Abstract
Concurrent wasting and stunting (WaSt) is a serious form of malnutrition among young children, particularly vulnerable groups affected by the conflict. Understanding the prevalence and risk factors of WaSt among vulnerable children is important to develop effective intervention measures to reduce the burden of WaSt. The present study aimed to identify the prevalence of and risk factors for WaSt among marginalised children aged 6-59 months in Sana'a city, Yemen. A community-based cross-sectional design was conducted on a total sample size of 450 marginalised children aged 6-59 months who lived at home with their mothers. Multivariable logistic regression analysis was performed and the prevalence of WaSt was found to be 10⋅7 %. Children aged 24-59 months were protected from WaSt (adjusted odds ratio (AOR) 0⋅40, 95 % confidence interval (CI) 0⋅21, 0⋅75). A higher prevalence of WaSt was associated with male sex (AOR 2⋅31, 95 % CI 1⋅13, 4⋅71), no history of being breastfed (AOR 3⋅57, 95 % CI 1⋅23, 10⋅39), acute diarrhoea (AOR 2⋅12, 95 % CI 1⋅12, 4⋅02) and family income sources of assistance from others (AOR 2⋅74, 95 % CI 1⋅08, 6⋅93) or salary work (AOR 2⋅22, 95 % CI 1⋅10, 4⋅47). Continued breast- and bottle-feeding were not associated with WaSt in children aged 6-23 months. Mothers' age, education and work status, family size and drinking water source were not associated with WaSt. Overall, we found that the prevalence of WaSt among marginalised children remained high. Interventions to improve household income, hygienic conditions and child feeding practices are necessary to promote child growth.
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Affiliation(s)
- Mansour Abdu Al-Taj
- Department of Community Medicine, Faculty of Medicine and Health Sciences, Sana'a University, Sana'a, Yemen
| | - Abdulwahed Al Serouri
- Field Epidemiology Training Programme, Ministry of Public Health and Population, Sana'a, Yemen
| | | | | | - Nada Nabil Al-faeq
- Faculty of Medicine and Health Sciences, Sana'a University, Sana'a, Yemen
| | | | | | - Ali Mujahed Nawfal
- Faculty of Medicine and Health Sciences, Sana'a University, Sana'a, Yemen
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Muindi K, Iddi S, Gitau H, Mberu B. Housing and health outcomes: evidence on child morbidities from six Sub-Saharan African countries. BMC Pediatr 2023; 23:219. [PMID: 37147616 PMCID: PMC10163804 DOI: 10.1186/s12887-023-03992-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Accepted: 04/05/2023] [Indexed: 05/07/2023] Open
Abstract
BACKGROUND The connection between healthy housing status and health is well established. The quality of housing plays a significant role in infectious and non-communicable as well as vector-borne diseases. The global burden of disease attributable to housing is considerable with millions of deaths arising from diarrheal and respiratory diseases annually. In sub-Saharan Africa (SSA), the quality of housing remains poor although improvements have been documented. There is a general dearth of comparative analysis across several countries in the sub-region. We assess in this study, the association between healthy housing and child morbidity across six countries in SSA. METHODS We use the Demographic and Health Survey (DHS) data for six countries where the most recent survey collected health outcome data on child diarrhoea, acute respiratory illness, and fever. The total sample size of 91,096 is used in the analysis (representing 15, 044 for Burkina Faso, 11, 732 for Cameroon, 5, 884 for Ghana, 20, 964 for Kenya, 33, 924 for Nigeria, and 3,548 for South Africa). The key exposure variable is healthy housing status. We control for various factors associated with the three childhood health outcomes. These include quality housing status, residency (rural/urban), age of the head of the household, mother's education, mother's BMI status, marital status, mother's age, and religious status. Others include the child's gender, age, whether the child is from multiple or single births, and breastfeeding status. Inferential analysis using survey-weighted logistic regression is employed. RESULTS Our findings indicate that housing is an important determinant of the three outcomes investigated. Compared to unhealthier housing, healthy housing status was found to be associated with reduced odds of diarrhoea in Cameroon [Healthiest: aOR = 0.48, 95% CI, (0.32,0.71), healthier: aOR = 0.50, 95% CI,(0.35,0.70), Healthy: aOR = 0.60, 95% CI, (0.44,0.83), Unhealthy: aOR = 0.60, 95% CI, (0.44,0.81)], Kenya [Healthiest: aOR = 0.68, 95% CI, (0.52,0.87), Healtheir: aOR = 0.79, 95% CI, (0.63,0.98), Healthy: aOR = 0.76, 95% CI, (0.62,0.91)], South Africa[Healthy: aOR = 0.41, 95% CI, (0.18, 0.97)], and Nigeria [Healthiest: aOR = 0.48, 95% CI,(0.37,0.62), Healthier: aOR = 0.61, 95% CI,(0.50,0.74), Healthy: aOR = 0.71, 95%CI, (0.59,0.86), Unhealthy: aOR = 0.78, 95% CI, (0.67,0.91)], and reduced odds of Acute Respiratory Infection in Cameroon [Healthy: aOR = 0.72, 95% CI,(0.54,0.96)], Kenya [Healthiest: aOR = 0.66, 95% CI, (0.54,0.81), Healthier: aOR = 0.81, 95% CI, (0.69,0.95)], and Nigeria [Healthiest: aOR = 0.69, 95% CI, (0.56,0.85), Healthier: aOR = 0.72, 95% CI, (0.60,0.87), Healthy: aOR = 0.78, 95% CI, (0.66,0.92), Unhealthy: aOR = 0.80, 95% CI, (0.69,0.93)] while it was associated with increased odds in Burkina Faso [Healthiest: aOR = 2.45, 95% CI, (1.39,4.34), Healthy: aOR = 1.55, 95% CI, (1.09,2.20)] and South Africa [Healthy: aOR = 2.36 95% CI, (1.31, 4.25)]. In addition, healthy housing was significantly associated with reduced odds of fever among children in all countries except South Africa [Healthiest: aOR = 2.09, 95% CI, (1.02, 4.29)] where children living in the healthiest homes had more than double the odds of having fever. In addition, household-level factors such as the age of the household head, and place of residence were associated with the outcomes. Child-level factors such as breastfeeding status, age, and sex, and maternal-level factors such as education, age, marital status, body mass index (BMI), and religion were also associated with the outcomes. CONCLUSIONS The dissimilarity of findings across similar covariates and the multiple relations between healthy housing and under 5 morbidity patterns show unequivocally the heterogeneity that exists across African countries and the need to account for different contexts in efforts to seek an understanding of the role of healthy housing in child morbidity and general health outcomes.
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Affiliation(s)
- Kanyiva Muindi
- Population Dynamics and Urbanization, African Population and Health Research Center, Nairobi, Kenya.
| | - Samuel Iddi
- Population Dynamics and Urbanization, African Population and Health Research Center, Nairobi, Kenya.
- Department of Statistics and Actuarial Science, University of Ghana, Legon, Accra, Ghana.
| | - Hellen Gitau
- Population Dynamics and Urbanization, African Population and Health Research Center, Nairobi, Kenya
| | - Blessing Mberu
- Population Dynamics and Urbanization, African Population and Health Research Center, Nairobi, Kenya
- Demography and Population Studies, University of Witwatersrand, Johannesburg, South Africa
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Hossain S, Mihrshahi S. Exclusive Breastfeeding and Childhood Morbidity: A Narrative Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14804. [PMID: 36429518 PMCID: PMC9691199 DOI: 10.3390/ijerph192214804] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 11/06/2022] [Accepted: 11/08/2022] [Indexed: 06/16/2023]
Abstract
Globally, diarrheal diseases and acute respiratory infections are the leading causes of morbidity and mortality in children under 5 years old. The benefits of exclusive breastfeeding in reducing the risk of gastrointestinal and respiratory infections are well documented. Optimal breastfeeding may potentially save the lives of about 800,000 children in low-income settings. Despite the evidence, around 63% of infants from birth to 6 months are not exclusively breastfed worldwide. We searched the literature published between 2010 and 2022 in Medline, Embase, and Scopus on the association between exclusive breastfeeding and infectious diseases. We selected and reviewed 70 relevant studies. Our findings expand and confirm the positive association between exclusive breastfeeding and reduced risk of a number of gastrointestinal, respiratory, and other infections in 60 out of 70 studies observed in both low- and high-income settings. Several studies analyzing exclusive breastfeeding duration reported that a longer exclusive breastfeeding duration is protective against many infectious diseases. This review also reported a lack of standardized definition for measuring exclusive breastfeeding in many studies. Overall, the results highlight the benefits of exclusive breastfeeding in many studies and suggests reporting exclusive breastfeeding in future studies using a consistent definition to enable better monitoring of exclusive breastfeeding rates.
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Borg B, Gribble K, Courtney‐Haag K, Parajuli KR, Mihrshahi S. Association between early initiation of breastfeeding and reduced risk of respiratory infection: Implications for nonseparation of infant and mother in the COVID‐19 context. MATERNAL & CHILD NUTRITION 2022; 18:e13328. [PMID: 35137545 PMCID: PMC9115244 DOI: 10.1111/mcn.13328] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 01/19/2022] [Accepted: 01/21/2022] [Indexed: 12/19/2022]
Affiliation(s)
- Bindi Borg
- School of Public Health University of Sydney Sydney New South Wales Australia
| | - Karleen Gribble
- School of Nursing and Midwifery Western Sydney University Penrith New South Wales Australia
| | | | | | - Seema Mihrshahi
- School of Public Health University of Sydney Sydney New South Wales Australia
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Effect of maternal nutrition education on early initiation and exclusive breast-feeding practices in south Ethiopia: a cluster randomised control trial. J Nutr Sci 2022; 11:e37. [PMID: 35720173 PMCID: PMC9161038 DOI: 10.1017/jns.2022.36] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Abstract
Introduction: Optimal breast-feeding practices make a major contribution to the promotion of healthy growth and development through much prevention of diarrheal and respiratory diseases which majorly cause morbidity and mortality in under-five children. However, breast-feeding practices remain suboptimality in Ethiopia. Objective: The study objective was to determine the effect of maternal nutrition education on early initiation and exclusive breast-feeding practice in the Hawela Tulla sub-city. Methods: A cluster randomised, parallel-group, single-blinded trial was used. About 310 pregnant women (155 for the intervention group and 155 for the control group) were included. Result: An early initiation of breast-feeding was significantly higher among women who received breast-feeding education than those who did not receive (104(72·7 %) v. 85(59·9 %), P = 0·022) and exclusive breast-feeding practice was also significantly higher among women who received breast-feeding education than those who did not receive (106(74·1 %) v. 86(60·6 %), P = 0·015). Breast-feeding education [AORs 1·55, 95 % CI (1·02, 2·36)], institutional delivery [AOR 2·29, 95 % CI (1·21, 4·35)], vaginal delivery [AOR 2·85, 95 % CI (1·61, 5·41)] and pre-lacteal feeding [AOR 0·47, 95 % CI (0·25, 0·85)] were predictors of early initiation of breast-feeding. Breast-feeding education [AOR 1·72, 95 % CI (1·12, 2·64)] and institutional delivery [AOR 2·36, 95 % CI (1·28, 4·33)] were also determinants of exclusive breast-feeding practices. Conclusion: Breast-feeding education improved early initiation of breast-feeding and exclusive breast-feeding practices. Providing sustained education to women regarding early initiation and exclusive breast-feeding practice should be strengthened.
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Fatimah, Massi MN, Febriani ADB, Hatta M, Karuniawati A, Rauf S, Wahyuni S, Hamid F, Alasiry E, Patellongi I, Permatasari TAE, Farsida. The role of exclusive breastfeeding on sIgA and lactoferrin levels in toddlers suffering from Acute Respiratory Infection: A cross-sectional study. Ann Med Surg (Lond) 2022; 77:103644. [PMID: 35638033 PMCID: PMC9142618 DOI: 10.1016/j.amsu.2022.103644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 04/14/2022] [Accepted: 04/15/2022] [Indexed: 10/28/2022] Open
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Al-Anazi OM, Mohammad Haneef MS, Zafar M, Ahsan M. Association of Maternal Obesity and Diabetes Mellitus with Exclusive Breastfeeding Among Saudi Mothers in Jubail, Saudi Arabia. Int J Prev Med 2022; 13:68. [PMID: 35706874 PMCID: PMC9188902 DOI: 10.4103/ijpvm.ijpvm_61_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Accepted: 06/10/2020] [Indexed: 11/17/2022] Open
Abstract
Background Obesity and diabetes are common public health issues in Saudi Arabia. The aim of this study is to evaluate the association of maternal obesity and diabetes with exclusive breastfeeding among Saudi Mothers at the Royal Commission Service Primary Health Care Centers in Jubail City, Saudi Arabia. Methods It is a cross-sectional study and 360 mothers were selected from primary health center through a simple random sampling. A validated and structured questionnaire was used. Body mass index was used for calculation of obesity and fasting blood sugar to find out the diabetic status. Chi-square test was used to assessing the difference between obese and nonobese and diabetic and nondiabetic group with respect to exclusive breastfeeding. Logistic regression was used to determine the association of obesity and diabetes with exclusive breastfeeding. Results Obesity and diabetic prevalence among study participants were 81.9% and 65.5%, respectively. Exclusive breastfeeding prevalence among total study participants was 36.9%. Among obese, it was 28.8% and diabetes, it was 29.1% and this difference is statistically significant when compared to nonobese and nondiabetic group (P-value 0.04). The obese [OR1.30 (1.12-4.85) with P value 0.02] and diabetic [OR 1.56 (1.35-3.9) with P value 0.00] mothers were more than one time more likely associated with nonexclusive breastfeeding. Conclusions The study concludes that the rate of exclusive breastfeeding decreased among obese and diabetic mothers and the positive association of obese and diabetes with nonexclusive breastfeeding. Intervention is required to reduce the prevalence of obesity and diabetic among breastfeeding mothers.
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Affiliation(s)
- Ohud Mohammed Al-Anazi
- Department of Public Health, College of Public Health, Imamm Abdul Rahman Bin Faisal university, Dammam, Saudi Arabia
| | | | - Mubashir Zafar
- Department of Public Health, College of Public Health, Imamm Abdul Rahman Bin Faisal university, Dammam, Saudi Arabia,Address for correspondence: Dr. Mubashir Zafar, Department of Public Health, College of Public Health, Imamm Abdul Rehman Bin Faisal University, Dammam, Kingdom of Saudi Arabia.
| | - Mohammad Ahsan
- Department of Physical Therapy, College of Applied Medical Sciences, Imam Abdul Rahman Bin Faisal University, Dammam, Saudi Arabia
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Nutritional Composition of Traditional Complementary Foods in Nigeria and Health / Developmental Outcomes: A Systematic Review. SCIENTIFIC AFRICAN 2022. [DOI: 10.1016/j.sciaf.2022.e01203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Rahman MA, Khan MN, Akter S, Rahman A, Alam MM, Khan MA, Rahman MM. Determinants of exclusive breastfeeding practice in Bangladesh: Evidence from nationally representative survey data. PLoS One 2020; 15:e0236080. [PMID: 32667942 PMCID: PMC7363092 DOI: 10.1371/journal.pone.0236080] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2019] [Accepted: 06/30/2020] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Exclusive breastfeeding (EBF) means that an infant should be breastfed only for the first six months of life to achieve optimal child development and to prevent infant morbidity and mortality. The aim of this analysis was to determine the individual-, household-, and community-level factors associated with EBF practice in Bangladesh. METHODS A total of 1,440 women-child pairs data were analysed extracted from 2011 and 2014 Bangladesh Demographic and Health Survey. Multilevel logistic regression models were used separately for individual-, household-, and community level factors to identify the different level of factors associated with EBF practice. RESULTS Around 61% women in Bangladesh practiced EBF with significant variation across several individual-, household-, and community-level factors. At the individual level, higher odds of EBF practice was found among mothers' received higher number of antenatal care and lower age of child. Mothers' higher education and engagement in formal jobs were found negatively associated with EBF practice. At the community level, higher odds of EBF was found among women live in Barishal, Dhaka, and Rajshahi divisions, and resided in the community with moderate level of female education, higher level of fertility, and higher use of antenatal and delivery care. CONCLUSIONS One in every three children in Bangladesh do not breastfeed exclusively which needs special attention for the policymakers. In this case, educated women engaged in income generating activities and women did not use antenatal care should be given priority. At the community level, priority should be given for the women's resides in the community with lower level of antenatal and delivery healthcare services use.
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Affiliation(s)
- Md. Aminur Rahman
- Department of Population Science and Human Resource Development, University of Rajshahi, Rajshahi, Bangladesh
| | - Md. Nuruzzaman Khan
- Department of Population Sciences, Jatiya Kabi Kazi Nazrul Islam University, Mymensingh, Bangladesh
- * E-mail:
| | - Shahinoor Akter
- Department of Anthropology, Jagannath University, Dhaka, Bangladesh
| | - Azizur Rahman
- Department of Public Administration and Governance Studies, Jatiya Kabi Kazi Nazrul Islam University, Mymensingh, Bangladesh
| | - Md. Mahmudul Alam
- Department of Statistics, University of Rajshahi, Rajshahi, Bangladesh
| | - Md. Alam Khan
- Department of Pharmacy, University of Rajshahi, Rajshahi, Bangladesh
| | - Md. Mostafizur Rahman
- Department of Population Science and Human Resource Development, University of Rajshahi, Rajshahi, Bangladesh
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Dhami MV, Ogbo FA, Diallo TM, Agho KE. Regional Analysis of Associations between Infant and Young Child Feeding Practices and Diarrhoea in Indian Children. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E4740. [PMID: 32630337 PMCID: PMC7370018 DOI: 10.3390/ijerph17134740] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/31/2020] [Revised: 06/24/2020] [Accepted: 06/25/2020] [Indexed: 11/07/2022]
Abstract
Studies on the association between infant and young child feeding (IYCF) practices and diarrhoea across regional India are limited. Hence, we examined the association between IYCF practices and diarrhoea in regional India. A weighted sample of 90,596 (North = 11,200, South = 16,469, East = 23,317, West = 11,512, Central = 24,870 and North-East = 3228) from the 2015-2016 National Family Health Survey in India was examined, using multivariate logistic regressions that adjust for clustering and sampling weights. The IYCF indicators included early initiation of breastfeeding (EIBF), exclusive breastfeeding (ExcBF), predominant breastfeeding (PBF), bottle feeding (BotF), continued breastfeeding (BF) at one-year, continued BF at two years, children ever breastfed and the introduction of solid, semi-solid or soft foods (ISSSF). Diarrhoea prevalence was lower among infants who were BF within one-hour of birth and those who were exclusively breastfed. Multivariate analyses revealed that continued BF at one and two years, and infants who were introduced to complementary foods had a higher prevalence of diarrhoea. EIBF and ExcBF were protective against diarrhoea in the regions of North, East and Central India. PBF, BotF and ISSSF were risk factors for diarrhoea in Central India. Continued BF at two years was a risk factor for diarrhoea in Western India. Findings suggested that EIBF and ExcBF were protective against diarrhoea in Northern, Eastern and Central India, while PBF, BotF, continued BF at two years and ISSSF were risk factors for diarrhoea in various regions in India. Improvements in IYCF practices are likely to reduce the burden of diarrhoea-related morbidity and mortality across regions in India.
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Affiliation(s)
- Mansi Vijaybhai Dhami
- Translational Health Research Institute (THRI), School of Medicine, Western Sydney University, Campbelltown Campus, Penrith, NSW 2571, Australia; (F.A.O.); (K.E.A.)
| | - Felix Akpojene Ogbo
- Translational Health Research Institute (THRI), School of Medicine, Western Sydney University, Campbelltown Campus, Penrith, NSW 2571, Australia; (F.A.O.); (K.E.A.)
- General Practice Unit, Prescot Specialist Medical Centre, Welfare Quarters, Makurdi, Benue State 972261, Nigeria
| | - Thierno M.O. Diallo
- School of Social Sciences, Western Sydney University, Penrith Campus, Penrith, NSW 2571, Australia;
- Statistiques & M. N., Sherbrooke, QC J1K 2Z4, Canada
| | - Kingsley E. Agho
- Translational Health Research Institute (THRI), School of Medicine, Western Sydney University, Campbelltown Campus, Penrith, NSW 2571, Australia; (F.A.O.); (K.E.A.)
- African Vision Research Institute (AVRI), University of KwaZulu-Natal, Durban 4041, South Africa
- School of Health Sciences, Western Sydney University, Campbelltown Campus, Penrith, NSW 2571, Australia
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Ahmed KY, Page A, Arora A, Ogbo FA. Associations between infant and young child feeding practices and acute respiratory infection and diarrhoea in Ethiopia: A propensity score matching approach. PLoS One 2020; 15:e0230978. [PMID: 32236145 PMCID: PMC7112197 DOI: 10.1371/journal.pone.0230978] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Accepted: 03/12/2020] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND Acute respiratory infection (ARI) and diarrhoea are the leading causes of childhood morbidity and mortality in Ethiopia. Understanding the associations between infant and young child feeding (IYCF) and ARI and diarrhoea can inform IYCF policy interventions and advocacy in Ethiopia. This study aimed to investigate the relationship between IYCF practices and ARI and diarrhoea in Ethiopian children. METHODS This study used the Ethiopia Demographic and Health Survey (EDHS) data for the years 2000 (n = 3680), 2005 (n = 3528), 2011 (n = 4037), and 2016 (n = 3861). The association between IYCF practices and (i) ARI and (ii) diarrhoea were investigated using propensity score matching and multivariable logistic regression models. The IYCF practices include early initiation of breastfeeding, exclusive breastfeeding (EBF), predominant breastfeeding, introduction of complementary foods, continued breastfeeding at two years and bottle feeding. RESULTS Infants and young children who were breastfed within 1-hour of birth and those who were exclusively breastfed had a lower prevalence of ARI. Infants who were exclusively and predominantly breastfed had a lower prevalence of diarrhoea. Early initiation of breastfeeding (Odds ratio [OR]: 0.81; 95% confidence interval [CI]: 0.72, 0.92) and EBF (OR: 0.65; 95% CI: 0.51, 0.83) were associated with lower risk of ARI. Bottle-fed children had higher odds of ARI (OR: 1.36; 95% CI: 1.10, 1.68). Early initiation of breastfeeding and EBF were associated with lower odds of diarrhoea (OR: 0.88; 95% CI: 0.79, 0.94 for Early initiation of breastfeeding and OR: 0.51; 95% CI: 0.39, 0.65 for EBF). Infants who were predominantly breastfed were less likely to experience diarrhoea (OR: 0.69; 95% CI: 0.53, 0.89). CONCLUSION The recommended best practices for preventing ARI and diarrhoeal diseases in infants and young children namely: the early initiation of breastfeeding, EBF and avoidance of bottle feeding should be institutionalized and scale-up in Ethiopia as part of implementation science approach to cover the know-do-gaps.
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Affiliation(s)
- Kedir Y. Ahmed
- College of Medicine and Health Sciences, Samara University, Samara, Ethiopia
- Translational Health Research Institute, Western Sydney University, Campbelltown, NSW, Australia
| | - Andrew Page
- Translational Health Research Institute, Western Sydney University, Campbelltown, NSW, Australia
| | - Amit Arora
- Translational Health Research Institute, Western Sydney University, Campbelltown, NSW, Australia
- School of Science and Health, Western Sydney University, Campbelltown, NSW, Australia
- Oral Health Services, Sydney Local Health District and Sydney Dental Hospital, NSW Health, Sydney, Australia
- Discipline of Child and Adolescent Health, Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Felix Akpojene Ogbo
- Translational Health Research Institute, Western Sydney University, Campbelltown, NSW, Australia
- General Practice Unit, Prescot Specialist Medical Centre Makurdi, Makurdi, Benue State, Nigeria
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17
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Do Differences in Prelacteal Feeding Explain Differences in Subsequent Breastfeeding Between Haiti and the Dominican Republic? Matern Child Health J 2020; 24:462-471. [PMID: 32030532 DOI: 10.1007/s10995-020-02891-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
OBJECTIVE Although Haiti and the Dominican Republic (DR) share the same island of Hispaniola, exclusive breastfeeding is much higher in Haiti. As prelacteal feeding also differs between the two countries, it was hypothesize that prelacteal feeding would account for the subsequent differences in breastfeeding exclusivity between the two countries, while controlling for other potentially influencing differences. METHODS Data for infants under 6 months of age were extracted from the cross-sectional Demographic and Health Surveys from Haiti (2012) and the DR (2013). Bivariate analysis and ordered logistic regression models were used. RESULTS Data were available for 686 Haitian infants [mean age: 2.9 (SD: 1.6) months] and 264 Dominican infants [mean age: 2.6 (SD: 1.6) months]. Haitian infants were more likely to be exclusively breastfed than Dominican infants, 41.3% versus 8.0%, at the time of the survey, and less likely to have been exposed to any prelacteal feeds, 20.1% versus 69.8%, respectively. Furthermore, Dominican infants were more likely to have been exposed to milk-based prelacteal feeds. Dominican status, any prelacteal feeds, and milk-based prelacteal feeds significantly and independently reduced the odds of breastfeeding exclusivity. CONCLUSIONS FOR PRACTICE Identification of factors beyond prelacteal feeding are necessary to explain the substantially lower breastfeeding exclusivity in the DR compared to Haiti and to determine why so many Dominican infants are exposed to milk-based prelacteal feeds.
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Nguyen P, Binns CW, Ha AVV, Chu TK, Nguyen LC, Duong DV, Do DV, Lee AH. Prelacteal and early formula feeding increase risk of infant hospitalisation: a prospective cohort study. Arch Dis Child 2020; 105:122-126. [PMID: 31523040 DOI: 10.1136/archdischild-2019-316937] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Revised: 08/05/2019] [Accepted: 08/06/2019] [Indexed: 01/20/2023]
Abstract
OBJECTIVE To ascertain the relationship between prelacteal feeding, early formula feeding and adverse health outcomes, especially hospitalisation during the first year of life. DESIGN Multicentre prospective cohort study. SETTING Six hospitals across three cities in Vietnam. PATIENTS A total of 2030 pregnant women were recruited at 24-28 weeks of gestation and followed up at hospital discharge, 1, 3, 6 and 12 months post partum. MAIN OUTCOME MEASURES Rates of infant hospitalisation, diarrhoea and lower respiratory tract infection during the first 12 months. RESULTS For the final complete sample (n=1709, 84%), about one-quarter of the infants experienced diarrhoea (25.5%) or were admitted to hospital with at least one episode (24.8%), and almost half (47.6%) the cohort contracted lower respiratory tract infection by 12 months. The prevalence of prelacteal feeding was high (56.5%) while formula feeding was common (79.5%) before hospital discharge, both of which increased the risks of adverse health outcomes particularly hospitalisation by approximately 1.5-fold, with adjusted OR (95% CI) 1.43 (1.09 to 1.88) and 1.48 (1.07 to 2.05), respectively for these infants by 12 months, when compared with others who were exclusively breast fed. CONCLUSIONS Prelacteal feeding and early formula feeding before hospital discharge are associated with higher risks of infection and hospital admission in Vietnamese infants. Support for exclusive breast feeding should be provided to mothers to avoid the adverse consequences of giving formula milk and prelateal foods.
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Affiliation(s)
- Phung Nguyen
- Faculty of Public Health, University of Medicine and Pharmacy at Ho Chi Minh, Ho Chi Minh City, Vietnam .,School of Public Health, Curtin University Bentley Campus, Perth, Western Australia, Australia
| | - Colin W Binns
- School of Public Health, Curtin University Bentley Campus, Perth, Western Australia, Australia
| | - Anh Vo Van Ha
- School of Public Health, Curtin University Bentley Campus, Perth, Western Australia, Australia.,Faculty of Public Health, Pham Ngoc Thach University of Medicine, Ho Chi Minh City, Vietnam
| | - Tan Khac Chu
- School of Public Health, Curtin University Bentley Campus, Perth, Western Australia, Australia.,Faculty of Public Health, Hai Phong Medical University, Hai Phong, Vietnam
| | - Luat Cong Nguyen
- School of Public Health, Curtin University Bentley Campus, Perth, Western Australia, Australia.,National Immunization Program, National Institute of Hygiene and Epidemiology, Hanoi, Vietnam
| | - Dat Van Duong
- School of Public Health, Curtin University Bentley Campus, Perth, Western Australia, Australia
| | - Dung Van Do
- Faculty of Public Health, University of Medicine and Pharmacy at Ho Chi Minh, Ho Chi Minh City, Vietnam
| | - Andy H Lee
- School of Public Health, Curtin University Bentley Campus, Perth, Western Australia, Australia
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Acharya D, Singh JK, Kandel R, Park JH, Yoo SJ, Lee K. Maternal Factors and the Utilization of Maternal Care Services Associated with Infant Feeding Practices among Mothers in Rural Southern Nepal. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16111887. [PMID: 31142032 PMCID: PMC6603766 DOI: 10.3390/ijerph16111887] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Revised: 05/21/2019] [Accepted: 05/21/2019] [Indexed: 12/18/2022]
Abstract
This study aimed to investigate the maternal factors and utilization of maternal care services associated with infant feeding practices in rural areas of Southern Nepal. Data from a cluster randomized controlled trial ‘MATRI-SUMAN’(Maternal Alliance for Technological Research Initiative on Service Utilization and Maternal Nutrition) conducted between 2015–2016 were analyzed. A total of 426 pregnant women in their second trimester were recruited from the MATRI-SUMAN trial, which was conducted on six villages in rural areas of the Dhanusha district, Nepal. A total of 379 mothers that had ever breastfed their infants, and followed for at least seven months after birth were included in the analysis. Multivariate logistic regression analysis was used to identify independent risk factors associated with child feeding practices after controlling for potential confounders. Of the 379 mothers, 41.4%, 53%, and 43% initiated breast feeding within the first hour of birth (EIBF), practiced exclusive breastfeeding (EBF), and initiated timely complementary feeding (CF) at six months, respectively. Multiple logistic regression results revealed that maternal education (secondary or higher), an occupation in the service/business/household sectors, receipt of MATRI-SUMAN intervention, more than four ANC (antenatal care) visits, and delivery in a health facility were associated with higher odds ratios of EIBF. Similarly, mothers with a primary, secondary and higher level of education, that worked in the service/business/household sectors, primiparous mothers, those that received MATRI-SUMAN intervention, visited ANC more than four times, and made a PNC (postnatal care) visit had higher odds ratios of EBF, while mothers who were 35–45 years of age were less likely to have used EBF. In addition, education to the secondary or a higher level, a male baby, receipt of MATRI-SUMAN intervention and a PNC visit had higher odds ratios of CF initiation at six months. The promotion of maternal ANC visits, birth at a health institution, and postnatal visits should be recommended in order to improve child feeding practices in Nepal.
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Affiliation(s)
- Dilaram Acharya
- Department of Preventive Medicine, College of Medicine, Dongguk University, Gyeongju 38066, Korea.
- Department of Community Medicine, Kathmandu University, Devdaha Medical College and Research Institute, Rupandehi 32907, Nepal.
| | - Jitendra Kumar Singh
- Department of Community Medicine and Public Health, Janaki Medical College, Tribhuvan University, Janakpur 44618, Nepal.
| | - Rajendra Kandel
- Personal Social Services Research Unit, London School of Economics and Political Science, London WC2A2AE, UK.
| | - Ji-Hyuk Park
- Department of Preventive Medicine, College of Medicine, Dongguk University, Gyeongju 38066, Korea.
| | - Seok-Ju Yoo
- Department of Preventive Medicine, College of Medicine, Dongguk University, Gyeongju 38066, Korea.
| | - Kwan Lee
- Department of Preventive Medicine, College of Medicine, Dongguk University, Gyeongju 38066, Korea.
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Nguyen PTH, Binns CW, Nguyen CL, Van Ha AV, Chu KT, Duong DV, Do DV, Lee AH. Physical Activity During Pregnancy is Associated with Improved Breastfeeding Outcomes: A Prospective Cohort Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16101740. [PMID: 31100948 PMCID: PMC6571814 DOI: 10.3390/ijerph16101740] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Revised: 05/10/2019] [Accepted: 05/14/2019] [Indexed: 11/28/2022]
Abstract
Physical activity is important for health, but little is known about associations between physical activity during pregnancy and breastfeeding. The aim of this study was to investigate any association between antenatal physical activity and breastfeeding duration. A prospective cohort of 2030 Vietnamese women, recruited between 24 and 28 week-gestation was followed up to twelve months postpartum. Physical activity was determined using the pregnancy physical activity questionnaire at baseline interview. Data was available for 1715 participants at 12 months, a 15.5% attrition rate. At 12 months 71.8% of mothers were still breastfeeding. A total of 20.9% women met physical activity targets and those mothers undertaking higher levels of physical activity had a lower risk of breastfeeding cessation by twelve months [hazard ratios HR = 0.59 (95% CI 0.47–0.74), p < 0.001, and HR = 0.74 (0.60–0.92), p = 0.006; respectively] when compared to the lowest tertile. Similarly, women with increased levels of physical activity have higher rates of breastfeeding at twelve months, compared to the lowest level [odds ratio OR = 1.71 (95% CI 1.29–2.25) and 1.38 (1.06–1.79)]. Higher levels of physical activity by pregnant women are associated with improved breastfeeding outcomes.
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Affiliation(s)
- Phung Thi Hoang Nguyen
- Faculty of Public Health, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City 700000, Vietnam.
- School of Public Health, Curtin University, Perth, WA 6845, Australia.
| | - Colin W Binns
- School of Public Health, Curtin University, Perth, WA 6845, Australia.
| | - Cong Luat Nguyen
- School of Public Health, Curtin University, Perth, WA 6845, Australia.
- National Institute of Hygiene and Epidemiology, Ha Noi 100000, Vietnam.
| | - Anh Vo Van Ha
- School of Public Health, Curtin University, Perth, WA 6845, Australia.
- Faculty of Public Health, Pham Ngoc Thach University of Medicine, Ho Chi Minh City 700000, Vietnam.
| | - Khac Tan Chu
- School of Public Health, Curtin University, Perth, WA 6845, Australia.
- Epidemiology Department, Hai Phong University of Medicine and Pharmacy, Hai Phong City 180000, Vietnam.
| | - Dat Van Duong
- School of Public Health, Curtin University, Perth, WA 6845, Australia.
| | - Dung Van Do
- Faculty of Public Health, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City 700000, Vietnam.
| | - Andy H Lee
- School of Public Health, Curtin University, Perth, WA 6845, Australia.
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Tongun JB, Sebit MB, Ndeezi G, Mukunya D, Tylleskar T, Tumwine JK. Prevalence and determinants of pre-lacteal feeding in South Sudan: a community-based survey. Glob Health Action 2019; 11:1523304. [PMID: 30295171 PMCID: PMC6179051 DOI: 10.1080/16549716.2018.1523304] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Background: Pre-lacteal feeding (PLF) is a barrier to optimal breastfeeding and increases the risk of diarrhoea and acute respiratory tract infections in infants.The prevalence and predictors of PLF are not well studied in South Sudan. Understanding the predictors of PLF is crucial in designing interventions to increase exclusive breastfeeding (EBF) rates. Objective: To assess the prevalence and factors associated with PLF in Jubek State, South Sudan. Method: This was a community based cross-sectional study of 810 mothers of children under two years of age in Jubek State, South Sudan. Mothers were interviewed in their homes using a semi-structured questionnaire to collect data on PLF, socio-demographic and birth characteristics. Multivariable analysis was used to identify factors independently associated with PLF. Results: A total of 426/810 (53 %), 95% confidence interval (CI) [48 %, 59 %] mothers had given pre-lacteal feeds to their infants. The commonest pre-lacteal feeds included glucose solution (54%), water (26%), and infant formula (14%). Having received antenatal breastfeeding counselling decreased the odds of PLF [adjusted odds ratio (AOR) 0.60; 95% CI (0.43, 0.82)]; while discarding of colostrum increased the use of pre-lacteal feeds [AOR 1.57; 95% CI (1.17, 2.11)]. Conclusion: The prevalence of PLF in South Sudan is high. Predictors of PLF included lack of breastfeeding counselling and discarding of colostrum. Infant feeding counselling should be given to all pregnant women in the health facilities and communities. The counselling should emphasize the health benefits of colostrum and discourage the practice of discarding it.
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Affiliation(s)
- Justin Bruno Tongun
- a Centre for International Health , University of Bergen , Bergen , Norway.,b Department of Paediatrics and Child Health , College of Medicine, University of Juba , Juba , South Sudan
| | - Mohamedi Boy Sebit
- c Department of Internal Medicine , College of Medicine, University of Juba , Juba , South Sudan
| | - Grace Ndeezi
- d Department of Paediatrics and Child Health, School of Medicine , College of Health Sciences, Makerere University , Kampala , Uganda
| | - David Mukunya
- a Centre for International Health , University of Bergen , Bergen , Norway
| | - Thorkild Tylleskar
- a Centre for International Health , University of Bergen , Bergen , Norway
| | - James K Tumwine
- d Department of Paediatrics and Child Health, School of Medicine , College of Health Sciences, Makerere University , Kampala , Uganda
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Bhandari S, Thorne-Lyman AL, Shrestha B, Neupane S, Nonyane BAS, Manohar S, Klemm RDW, West KP. Determinants of infant breastfeeding practices in Nepal: a national study. Int Breastfeed J 2019; 14:14. [PMID: 30988689 PMCID: PMC6448244 DOI: 10.1186/s13006-019-0208-y] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2018] [Accepted: 03/21/2019] [Indexed: 01/08/2023] Open
Abstract
Background Optimal breastfeeding practices, reflected by early initiation and feeding of colostrum, avoidance of prelacteal feeds, and continued exclusivity or predominance of breastfeeding, are critical for assuring proper infant nutrition, growth and development. Methods We used data from a nationally representative survey in 21 district sites across the Mountains, Hills and Terai (southern plains) of Nepal in 2013. Determinants of early initiation of breastfeeding, feeding of colostrum, prelacteal feeding and predominant breastfeeding were explored in 1015 infants < 12 months of age. Prelacteal feeds were defined as food/drink other than breast milk given to newborns in first 3 days. Predominant breastfeeding was defined as a child < 6 months of age is mainly breastfed, not fed solid/semi-solid foods, infant formula or non-human milk, in the past 7 days. Adjusted prevalence ratios (APR) and 95% confidence intervals (CI) were estimated, using log Poisson regression models with robust variance for clustering. Results The prevalence of breastfeeding within an hour of birth, colostrum feeding, prelacteal feeding and predominant breastfeeding was 41.8, 83.5, 32.7 and 57.2% respectively. Compared to infants not fed prelacteal feeds, infants given prelacteal feeds were 51% less likely to be breastfed within the first hour of birth (APR 0.49; 95% CI 0.36, 0.66) and 55% less likely to be predominantly breastfed (APR 0.45; 95% CI 0.32, 0.62). Infants reported to have received colostrum were more likely to have begun breastfeeding within an hour of birth (APR 1.26; 95% CI 1.04, 1.54) compared to those who did not receive colostrum. Infants born to mothers ≥ 20 years of age were less likely than adolescent mothers to initiate breastfeeding within 1 hour of birth. Infants in the Terai were 10% less likely to have received colostrum (APR 0.90; 95% CI 0.83, 0.97) and 2.72 times more likely to have received prelacteal feeds (APR 2.72; 95% CI 1.67, 4.45) than those in the Mountains. Conclusions Most infants in Nepal receive colostrum but less than half initiate breastfeeding within an hour of birth and one-third are fed prelacteal feeds, which may negatively affect breastfeeding and health throughout early infancy. Electronic supplementary material The online version of this article (10.1186/s13006-019-0208-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Shiva Bhandari
- PoSHAN Study Team, Lalitpur, Nepal.,2Department of Health Promotion, Education and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC USA
| | - Andrew L Thorne-Lyman
- 3Center for Human Nutrition, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD USA
| | | | | | - Bareng Aletta Sanny Nonyane
- 3Center for Human Nutrition, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD USA
| | - Swetha Manohar
- 3Center for Human Nutrition, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD USA
| | - Rolf D W Klemm
- 3Center for Human Nutrition, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD USA.,4Helen Keller International, New York, NY USA
| | - Keith P West
- 3Center for Human Nutrition, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD USA
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Vass RA, Kemeny A, Dergez T, Ertl T, Reglodi D, Jungling A, Tamas A. Distribution of bioactive factors in human milk samples. Int Breastfeed J 2019; 14:9. [PMID: 30792750 PMCID: PMC6371541 DOI: 10.1186/s13006-019-0203-3] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Accepted: 01/29/2019] [Indexed: 01/01/2023] Open
Abstract
Background Breast milk provides nutrition for infants and also contains a variety of bioactive factors that influence the development of the newborn. Human milk is a complex biological fluid that can be separated into different layers (water phase and lipid phase with its component water and lipid fractions). It can affect the developing human body along the whole length of the gastrointestinal tract, and through the circulation, its factors may reach every organ. Methods In the present study, we analyzed milk samples collected monthly for 6 months from 16 mothers from the 4th week postpartum between 2014 and 2016 in Baranya County, Hungary. The 96 samples provided us information about the fluctuation of certain bioactive factors during the first 6 months of lactation. We investigated with Luminex technology the concentrations of several cytokines (CD40, Flt-3L), chemokines (MCP-1, RANTES, GRO, MIP-1ß, MDC, eotaxin, fractalkine), and epidermal growth factor (EGF). Paired t-tests and one-way ANOVA followed by Bonferroni post-hoc tests were used to compare the data. Results We detected the presence of each bioactive factor in every layer of the milk samples during the first 6 months of breastfeeding in widespread concentration ranges. In the case of GRO, MIP-1ß, MDC, Flt-3L, fractalkine, and eotaxin, the concentrations were constant during the first 6 months of lactation. The water phase of human milk contained higher factor concentrations compared to both fractions of the lipid phase for most factors (except eotaxin and MIP-1ß). The concentrations of CD40, EGF, MCP-1, and RANTES in the first 3 months were significantly different compared to the values detected between 4th and 6th months. In the water phase, the level of MCP-1 was significantly decreased, while all of the other factors increased during the 4th through 6th months. We found significantly higher EGF, GRO, and RANTES levels in the water fraction compared to the lipid fraction of the lipid phase. Conclusions The novel findings of this investigation were the presence of Flt-3L and MDC in all layers of breast milk, and nearly all bioactive factors in the lipid phase. Due to their widespread physiological effects these factors may have an essential role in organogenesis.
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Affiliation(s)
- Reka A Vass
- 1Department of Anatomy, MTA-PTE PACAP Research Group, Centre for Neuroscience, Medical School, University of Pécs, Pécs, Hungary
| | - Agnes Kemeny
- 2Department of Pharmacology and Pharmacotherapy; Medical School, University of Pécs, Pécs, Hungary.,3Department of Medical Biology and Central Electron Microscope Laboratory, Medical School, University of Pécs, Pécs, Hungary
| | - Timea Dergez
- 4Institute of Bioanalysis, Medical School, University of Pécs, Pécs, Hungary
| | - Tibor Ertl
- 5Department of Obstetrics and Gynaecology, Medical School, University of Pécs, Pécs, Hungary
| | - Dora Reglodi
- 1Department of Anatomy, MTA-PTE PACAP Research Group, Centre for Neuroscience, Medical School, University of Pécs, Pécs, Hungary
| | - Adel Jungling
- 1Department of Anatomy, MTA-PTE PACAP Research Group, Centre for Neuroscience, Medical School, University of Pécs, Pécs, Hungary
| | - Andrea Tamas
- 1Department of Anatomy, MTA-PTE PACAP Research Group, Centre for Neuroscience, Medical School, University of Pécs, Pécs, Hungary
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Abstract
BACKGROUND: Researchers have shown beneficial influences of exclusive breastfeeding for women and infants. Therefore, the World Health Organization recommends exclusively breastfeeding infants for the first 6 months following birth. In Bhutan, researchers have found, through survey research, variable exclusive breastfeeding rates at 6 months. They have not, however, explored the experiences and views of participants in relation to breastfeeding. RESEARCH AIM: The aim was to explore first-time mothers' views, intentions, and experiences related to exclusive breastfeeding. METHODS: A qualitative, prospective, longitudinal, descriptive study was undertaken using semistructured, audio-recorded interviews at two points of time with first-time mothers prenatally during late third trimester ( n = 24) and at 6 weeks after birth ( n = 22). The framework approach to analysis was used to identify themes. RESULTS: Two themes (breastfeeding, but uncertainty about achieving exclusive breastfeeding and acceptance that breastfeeding is painful) were identified from interviews at term. Five themes were identified from interviews at 6 weeks after birth (lack of timely breastfeeding information and support from health professionals, misconceptions about exclusive breastfeeding, being unprepared for the reality of breastfeeding, limited control or choice over feeding, and adoption of cultural and traditional practices). CONCLUSION: The participants breastfed but did not practice exclusive breastfeeding due to a lack of timely breastfeeding information and inadequate breastfeeding support. While family elders supported breastfeeding, they also promoted the adoption of certain traditional and cultural practices, which affected exclusive breastfeeding.
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Affiliation(s)
- Kinga Pemo
- 1 School of Nursing and Midwifery, Deakin University, Geelong, Victoria, Australia
| | - Diane Phillips
- 1 School of Nursing and Midwifery, Deakin University, Geelong, Victoria, Australia
| | - Alison M Hutchinson
- 1 School of Nursing and Midwifery, Deakin University, Geelong, Victoria, Australia.,2 Centre for Quality and Patient Safety Research, Deakin University, Geelong, Victoria, Australia.,3 Centre for Quality and Patient Safety Research, Monash Health Partnership, Monash Medical Centre, Geelong, Victoria, Australia
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Bawankule R, Shetye S, Singh A, Singh A, Kumar K. Epidemiological investigation and management of bloody diarrhea among children in India. PLoS One 2019; 14:e0222208. [PMID: 31518363 PMCID: PMC6743764 DOI: 10.1371/journal.pone.0222208] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Accepted: 08/24/2019] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND The evidence on the factors associated with childhood bloody diarrhea in developing countries in general and India, in particular, is somewhat limited. Our study, therefore, examines-the prevalence of bloody diarrhea; the magnitude of treatment of bloody diarrhea (use of both oral rehydration and antibiotics (pills, syrups, and injections)); and several other associated factors with bloody diarrhea in the youngest children under five years in the Indian context. METHODS We used data from the National Family Health Survey (NFHS)-4 conducted in 2015-16. We used a multivariable binary logistic regression model to identify the factors associated with bloody diarrhea. We also applied a multinomial logistic regression model to identify associated factors with the treatment of bloody diarrhea amongst the youngest children below five years. FINDINGS The overall prevalence of bloody diarrhea in the youngest children was about 9 percent in the last two weeks preceding the survey. There was a significant difference in the mean age of those children having bloody diarrhea and watery diarrhea during the same period. Children whose stools were disposed of unsafely and those who belonged to households with neither a place nor water for washing hands were more likely to suffer from bloody diarrhea compared to their counterparts with these facilities. About a little less than one-fifth of the youngest children (16%) received adequate treatment of bloody diarrhea. The treatment of bloody diarrhea was associated with the health facility and maternal and children's socioeconomic and demographic characteristics. CONCLUSION The study shows that household environmental risk factors are important predictors of bloody diarrhea amongst the youngest children. Still, 28% of those children did not receive any treatment of bloody diarrhea in India. There is also a clear need to promote the practice of safe disposal of children's stools and handwashing among mothers and children. Mothers need to be sensitized about the necessity of an immediate visit to a health facility/center in case of bloody diarrhea.
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Affiliation(s)
- Rahul Bawankule
- International Institute for Population Sciences, Mumbai, India
- * E-mail:
| | - Sadanand Shetye
- B. K. L. Walawalkar Hospital and Rural Medical College, Kasarwadi-Sawarde, India
| | - Ashish Singh
- SJM School of Management, Indian Institute of Technology Bombay, Powai, Mumbai, India
| | - Abhishek Singh
- International Institute for Population Sciences, Mumbai, India
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Melku M, Alene KA, Terefe B, Enawgaw B, Biadgo B, Abebe M, Muchie KF, Kebede A, Melak T, Melku T. Anemia severity among children aged 6-59 months in Gondar town, Ethiopia: a community-based cross-sectional study. Ital J Pediatr 2018; 44:107. [PMID: 30176919 PMCID: PMC6122612 DOI: 10.1186/s13052-018-0547-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Accepted: 08/26/2018] [Indexed: 11/20/2022] Open
Abstract
Background Anemia is a public health problem affecting both developed and developing countries. Childhood anemia is associated with serious consequences including growth retardation, impaired motor and cognitive development, and increased morbidity and mortality. Hence, this study aimed at assessing the prevalence and factors associated with severity of anemia among children aged 6–59 months in Gondar town, northwest Ethiopia. Method A community-based cross-sectional study was conducted. A multi-stage sampling technique was employed to select study participants. Socio demographic and socioeconomic data were collected using a pre-tested structured questionnaire. Anthropometric measurements were taken as per WHO recommendation. Hemoglobin (Hb) concentration was measured using a portable HemoCue301 instrument (A Quest Diagnostic Company, Sweden). Mild anemia corresponds to a level of adjusted Hb of 10.0–10.9 g/dl; moderate anemia corresponds to a level of 7.0–9.9 g/dl, while severe anemia corresponds to a level less than 7.0 g/dl. Descriptive statistics were used to describe the study participants. Both bivariable and multivariable ordinal logistic regression were done, and proportional odds ratio (POR) with a 95% confidence interval (CI) was reported to show the strength of association. A p-value < 0.05 was considered statistically significant. Result Out of the total of 707 children included in this study, more than half (53.5%) of them were male. The median age of children was 30 months. Two hundred two (28.6%) of children were anemic: 124(17.5%) were mildly anemic, 73(10.3%) were moderately anemic, and 5 (0.7%) were severely anemic. The young age of the child, low frequency of child complementary feeding per day, primary maternal educational status, unmarried maternal marital status, and home delivery were factors associated with severity of childhood anemia. Conclusion Anemia among children aged 6–59 months in Gondar Town was a moderate public health problem. Improving access to education, providing regular health education about childcare and child feeding practices, strengthening the socioeconomic support for single-parent families and conducting regular community-based screening are recommended to reduce childhood anemia.
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Affiliation(s)
- Mulugeta Melku
- Department of Hematology and Immunohematology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
| | - Kefyalew Addis Alene
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Betelihem Terefe
- Department of Hematology and Immunohematology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Bamlaku Enawgaw
- Department of Hematology and Immunohematology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Belete Biadgo
- Department of Clinical Chemistry, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Molla Abebe
- Department of Clinical Chemistry, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Kindie Fentahun Muchie
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Asemarie Kebede
- School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Tadele Melak
- Department of Clinical Chemistry, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Tsedalu Melku
- School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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The influence of a community-level breast-feeding promotion intervention programme on breast-feeding practices in Myanmar. Public Health Nutr 2018; 21:3091-3100. [PMID: 30109844 DOI: 10.1017/s1368980018001799] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Breast-feeding in the first 6 months of life is critical for ensuring both child health and well-being. Despite efforts to improve breast-feeding practices, recent studies have reported that Myanmar continues to have low rates of exclusive breast-feeding.Design/Setting/SubjectsA community-based breast-feeding promotion programme using trained community members was implemented for 1 year in hard-to-reach townships of Myanmar. The present study assessed the breast-feeding practices using a cross-sectional survey of 610 mothers of children under 2 years old: specifically, breast-feeding within 24 h, exclusive breast-feeding up to 6 months and breast-feeding duration. RESULTS Using Cox models for breast-feeding duration before 24 months, the hazard of breast-feeding cessation was lower in programme v. non-programme townships (hazard ratio (HR)=0·55; 95 % CI 0·32, 0·95). Mothers who worked as shop owners or ran a family business had lower hazard of breast-feeding cessation (HR=0·13, P<0·05) v. those who worked as supervisors, managers, self-employed and businesswomen. The hazard of breast-feeding cessation was higher in women in higher wealth quintiles v. those in the lowest quintile (lower quintile, HR=3·49, P<0·1; higher quintile, HR=3·50, P<0·1; highest quintile, HR=3·47, P<0·1). CONCLUSIONS The intervention did not affect exclusive breast-feeding practices or breast-feeding within the first 24 h. Potential reasons include existing high levels of early initiation of breast-feeding due to ongoing government-led maternal and child health activities, and social and traditional practices related to complementary feeding. Community-based breast-feeding programmes should continue to promote exclusive breast-feeding and develop strategies to support working mothers.
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Bruno Tongun J, Sebit MB, Mukunya D, Ndeezi G, Nankabirwa V, Tylleskar T, Tumwine JK. Factors associated with delayed initiation of breastfeeding: a cross-sectional study in South Sudan. Int Breastfeed J 2018; 13:28. [PMID: 30002722 PMCID: PMC6034205 DOI: 10.1186/s13006-018-0170-0] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2017] [Accepted: 06/11/2018] [Indexed: 12/17/2022] Open
Abstract
Background The global breastfeeding recommendation states that all infants should be put to the breast within one hour of birth, which is defined as timely initiation or early initiation of breastfeeding. Early initiation of breastfeeding is associated with reduced risk in infant illness and death. Understanding the determinants of delay in initiation of breastfeeding might spur health staff and policy makers to foster timely breastfeeding. We assessed the prevalence and determinants of delay in initiation of breastfeeding among mothers in Juba Teaching Hospital. Methods The present study enrolled 806 mother-infant pairs within 24 hrs of birth in Juba Teaching Hospital in 2017. The mothers were interviewed about the time of initiation of breastfeeding, sociodemographic and birth characteristics. The independent variables associated with delay in initiation of breastfeeding were identified using multivariable logistic regression analysis. Results In the current study, 52% (418/806) of the mothers initiated breastfeeding later than one hour after birth. Birth by Caesarean section (Adjusted Odds Ratio [AOR] 41; 95% Confidence Interval [CI] 12.21, 138), discarding of colostrum (AOR 9.89; 95% CI 4.14, 23.62), unmarried mothers (AOR 3.76; 95% CI 1.53, 9.24), exposure to infant formula advertisement (AOR 1.82; 95% CI 1.09, 3.02) and no house ownership (AOR 1.52; 95% CI 1.11, 2.09) were independent factors associated with delay in initiation of breastfeeding. Conclusion We found that more than half of the mothers delayed the initiation of breastfeeding. Therefore, we recommend training on best breastfeeding practices and counselling skills for health staff in Juba Teaching Hospital. Policy dialogue, with the relevant ministries and departments on the promotion and protection of early initiation of breastfeeding is crucial.
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Affiliation(s)
- Justin Bruno Tongun
- 1Centre for International Health, University of Bergen, Bergen, Norway.,2Department of Paediatrics and Child Health, College of Medicine, University of Juba, Juba, South Sudan
| | - Mohammed Boy Sebit
- 3Department of Internal Medicine, College of Medicine, University of Juba, Juba, South Sudan
| | - David Mukunya
- 1Centre for International Health, University of Bergen, Bergen, Norway
| | - Grace Ndeezi
- 4Department of Paediatrics and Child Health, School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Victoria Nankabirwa
- 1Centre for International Health, University of Bergen, Bergen, Norway.,5School of Public Health, College of Health Sciences, Makerere University, Kampala, Uganda
| | | | - James K Tumwine
- 4Department of Paediatrics and Child Health, School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda
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Ogbo FA, Nguyen H, Naz S, Agho KE, Page A. The association between infant and young child feeding practices and diarrhoea in Tanzanian children. Trop Med Health 2018; 46:2. [PMID: 29422772 PMCID: PMC5791185 DOI: 10.1186/s41182-018-0084-y] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2017] [Accepted: 01/22/2018] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Diarrhoea is a leading cause of child mortality in Tanzania. The association between optimal infant feeding practices and diarrhoea has been reported elsewhere, but the evidence has been limited to promote and advocate for strategic interventions in Tanzania. This study examined the association between infant and young child feeding (IYCF) practices and diarrhoea in Tanzanian children under 24 months. METHODS The study used the Tanzania Demographic and Health Survey data to estimate the prevalence of diarrhoea stratified by IYCF practices. Using multivariable logistic regression modelling that adjusted for confounding factors and cluster variability, the association between IYCF practices and diarrhoea among Tanzanian children was investigated. RESULTS Diarrhoea prevalence was lower in infants aged 0-5 months whose mothers engaged in exclusive breastfeeding (EBF) and predominant breastfeeding (PBF) compared to those who were not exclusively and predominantly breastfed. Infants aged 6-8 months who were introduced to complementary foods had a higher prevalence of diarrhoea compared to those who received no complementary foods, that is, infants who were exclusively breastfed at 6-8 months. Infants who were exclusively and predominantly breastfed were less likely to experience diarrhoea compared to those who were not exclusively and predominantly breastfed [adjusted odds ratio (AOR) 0.31, 95% confidence interval (CI) 0.16-0.59, P < 0.001 for EBF and AOR = 0.30, 95% CI 0.10-0.89, P = 0.031 for PBF]. In contrast, infants aged 6-8 months who were introduced to complementary foods were more likely to experience diarrhoea compared to those who received no complementary foods (AOR = 2.91, 95% CI 1.99-4.27, P < 0.001). CONCLUSIONS The study suggests that EBF and PBF were protective against diarrhoeal illness in Tanzanian children, while the introduction of complementary foods was associated with the onset of diarrhoea. Strengthening IYCF (facility- and community-based) programmes would help to improve feeding behaviours of Tanzanian women and reduce diarrhoea burden in children under 2 years.
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Affiliation(s)
- Felix Akpojene Ogbo
- Translational Health Research Institute, School of Medicine, Western Sydney University, Campbelltown Campus, Locked Bag 1797, Penrith, NSW 2571 Australia
- Prescot Specialist Medical Centre, Makurdi, Benue State Nigeria
| | - Hillary Nguyen
- Translational Health Research Institute, School of Medicine, Western Sydney University, Campbelltown Campus, Locked Bag 1797, Penrith, NSW 2571 Australia
| | - Sabrina Naz
- Translational Health Research Institute, School of Medicine, Western Sydney University, Campbelltown Campus, Locked Bag 1797, Penrith, NSW 2571 Australia
| | - Kingsley E. Agho
- Translational Health Research Institute, School of Medicine, Western Sydney University, Campbelltown Campus, Locked Bag 1797, Penrith, NSW 2571 Australia
| | - Andrew Page
- Translational Health Research Institute, School of Medicine, Western Sydney University, Campbelltown Campus, Locked Bag 1797, Penrith, NSW 2571 Australia
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Hoche S, Meshesha B, Wakgari N. Sub-Optimal Breastfeeding and Its Associated Factors in Rural Communities of Hula District, Southern Ethiopia: A Cross-Sectional Study. Ethiop J Health Sci 2018; 28:49-62. [PMID: 29622907 PMCID: PMC5866289 DOI: 10.4314/ejhs.v28i1.7] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2017] [Accepted: 01/01/2018] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Sub-optimal breast feeding contributed a significant number of infants' death. Although breast feeding is universal in Ethiopia, the practice is not optimal. Hence, this study assessed the prevalence of sub-optimal breast feeding practice and its associated factors in rural communities of Hula District, Southern Ethiopia. METHODS A community based cross-sectional study was conducted among 634 women with infants aged 6 to 12 months. Multistage sampling technique was employed to select study subjects. Interviewer administered structured questionnaire was used for data collection. Data were entered and analyzed by using SPSS version 20.0. Bivariate and multivariate logistic regression was used to identify predictors of delayed initiation of breastfeeding and non-exclusive breastfeeding. RESULTS The prevalence of suboptimal breast feeding of infants was found to be 56.9%. Nearly half (49.4%) of the mothers delayed initiation of breast feeding, and 13.4% of the infants were fed breast non-exclusively. Having formal education [AOR: 1.74; 95% CI (1.17, 2.59)], family size < 5 [AOR=1.59; 95% CI (1.03, 2.45)], having one under five child [AOR=1.88; 95% CI (1.29, 2.75)], lower number of antenatal care visits [AOR= 2.40; 95% CI (1.68, 3.43)] and lack of counseling on breastfeeding [AOR= 1.69; 95% CI (1.19, 2.41)] were negatively associated with delayed initiation of breast feeding. Similarly, not attending formal education, low birth order and lack of knowledge about exclusive breastfeeding were also negatively associated with exclusive breastfeeding practice. CONCLUSION In this study, sub-optimal breast feeding was found to be high. Delayed initiation and non-exclusive breastfeeding practices were major contributors to sub-optimal breast feeding.
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Affiliation(s)
| | - Berhan Meshesha
- College of Medicine and Health Science, Hawassa University, Hawassa, Ethiopia
| | - Negash Wakgari
- School of Nursing and Midwifery, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia
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Smith ER, Locks LM, Manji KP, McDonald CM, Kupka R, Kisenge R, Aboud S, Fawzi WW, Duggan CP. Delayed Breastfeeding Initiation Is Associated with Infant Morbidity. J Pediatr 2017; 191:57-62.e2. [PMID: 29173323 PMCID: PMC8011584 DOI: 10.1016/j.jpeds.2017.08.069] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2017] [Revised: 07/06/2017] [Accepted: 08/24/2017] [Indexed: 12/14/2022]
Abstract
OBJECTIVE To assess the relationship between breastfeeding initiation time and postneonatal mortality, morbidity, and growth through 24 months in a cohort of Tanzanian infants. STUDY DESIGN We included 4203 infants from 2 trials of micronutrient supplementation. We used Cox proportional hazards models or general estimating equations to estimate relative risks. RESULTS A total of 13% of infants initiated breastfeeding >1 hour after birth (n = 536). There was no association between breastfeeding initiation time and risk of all-cause or cause-specific mortality, nor infant growth failure, from 6 weeks to 2 years of age. However, delayed breastfeeding was associated with an increased risk of several common infectious morbidities in early infancy, including upper respiratory infection symptoms and vomiting. Compared with those who initiated breastfeeding within the first hour of birth, delayed breastfeeding initiation was associated with an 11% increased risk of cough (relative risk 1.11, 95% CI 1.02-1.21) and a 48% increased risk of difficulty breathing (relative risk 1.48, 95% CI 1.09-2.01) during the first 6 months. Delayed initiation was associated with a greater risk of difficulty breathing from 6 to 12 months of age, but it was not associated with risk of any other morbidity during this time, nor any morbidity between 12 and 24 months. CONCLUSION Delayed breastfeeding initiation is associated with an increased risk of infant morbidity during the first 6 months of life. Early breastfeeding initiation, along with exclusive and prolonged breastfeeding, should be prioritized and promoted in efforts to improve child health.
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Affiliation(s)
- Emily R. Smith
- Division of Gastroenterology, Hepatology and Nutrition, Boston Children’s Hospital, Boston MA,Department of Global Health and Population, Harvard TH Chan School of Public Health, Boston MA
| | - Lindsey M. Locks
- Department of Nutrition, Harvard TH Chan School of Public Health, Boston MA
| | - Karim P. Manji
- Department of Pediatrics, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | | | - Roland Kupka
- Department of Nutrition, Harvard TH Chan School of Public Health, Boston MA,UNICEF Headquarters, New York, NY
| | - Rodrick Kisenge
- Department of Pediatrics, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Said Aboud
- Department of Microbiology and Immunology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Wafaie W. Fawzi
- Department of Global Health and Population, Harvard TH Chan School of Public Health, Boston MA,Department of Nutrition, Harvard TH Chan School of Public Health, Boston MA,Department of Epidemiology, Harvard TH Chan School of Public Health, Boston MA
| | - Christopher P. Duggan
- Division of Gastroenterology, Hepatology and Nutrition, Boston Children’s Hospital, Boston MA,Department of Global Health and Population, Harvard TH Chan School of Public Health, Boston MA,Department of Nutrition, Harvard TH Chan School of Public Health, Boston MA
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The impact of sociodemographic and health-service factors on breast-feeding in sub-Saharan African countries with high diarrhoea mortality. Public Health Nutr 2017; 20:3109-3119. [PMID: 28980521 DOI: 10.1017/s1368980017002567] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The current study aimed to examine the impact of sociodemographic and health-service factors on breast-feeding in sub-Saharan African (SSA) countries with high diarrhoea mortality. DESIGN The study used the most recent and pooled Demographic and Health Survey data sets collected in nine SSA countries with high diarrhoea mortality. Multivariate logistic regression models that adjusted for cluster and sampling weights were used to investigate the association between sociodemographic and health-service factors and breast-feeding in SSA countries. SETTING Sub-Saharan Africa with high diarrhoea mortality. SUBJECTS Children (n 50 975) under 24 months old (Burkina Faso (2010, N 5710); Demographic Republic of Congo (2013, N 6797); Ethiopia (2013, N 4193); Kenya (2014, N 7024); Mali (2013, N 3802); Niger (2013, N 4930); Nigeria (2013, N 11 712); Tanzania (2015, N 3894); and Uganda (2010, N 2913)). RESULTS Overall prevalence of exclusive breast-feeding (EBF) and early initiation of breast-feeding (EIBF) was 35 and 44 %, respectively. Uganda, Ethiopia and Tanzania had higher EBF prevalence compared with Nigeria and Niger. Prevalence of EIBF was highest in Mali and lowest in Kenya. Higher educational attainment and frequent health-service visits of mothers (i.e. antenatal care, postnatal care and delivery at a health facility) were associated with EBF and EIBF. CONCLUSIONS Breast-feeding practices in SSA countries with high diarrhoea mortality varied across geographical regions. To improve breast-feeding behaviours among mothers in SSA countries with high diarrhoea mortality, breast-feeding initiatives and policies should be context-specific, measurable and culturally appropriate, and should focus on all women, particularly mothers from low socio-economic groups with limited health-service access.
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Perea-Sanz L, Garcia-Llatas G, Lagarda MJ. Gangliosides in human milk and infant formula: A review on analytical techniques and contents. FOOD REVIEWS INTERNATIONAL 2017. [DOI: 10.1080/87559129.2017.1347671] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Laura Perea-Sanz
- Nutrition and Food Science Area, University of Valencia, Valencia, Spain
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Smith ER, Hurt L, Chowdhury R, Sinha B, Fawzi W, Edmond KM. Delayed breastfeeding initiation and infant survival: A systematic review and meta-analysis. PLoS One 2017; 12:e0180722. [PMID: 28746353 PMCID: PMC5528898 DOI: 10.1371/journal.pone.0180722] [Citation(s) in RCA: 125] [Impact Index Per Article: 17.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2017] [Accepted: 06/20/2017] [Indexed: 11/22/2022] Open
Abstract
Objective To assess the existing evidence regarding breastfeeding initiation time and infant morbidity and mortality. Study design We conducted a systematic review and meta-analysis. We searched Pubmed, Embase, Web of Science, CINAHL, Popline, LILACS, AIM, and Index Medicus to identify existing evidence. We included observational studies and randomized control trials that examined the association between breastfeeding initiation time and mortality, morbidity, or nutrition outcomes from birth through 12 months of age in a population of infants who all initiated breastfeeding. Two reviewers independently extracted data from eligible studies using a standardized form. We pooled effect estimates using fixed-effects meta-analysis. Results We pooled five studies, including 136,047 infants, which examined the association between very early breastfeeding initiation and neonatal mortality. Compared to infants who initiated breastfeeding ≤1 hour after birth, infants who initiated breastfeeding 2–23 hours after birth had a 33% greater risk of neonatal mortality (95% CI: 13–56%, I2 = 0%), and infants who initiated breastfeeding ≥24 hours after birth had a 2.19-fold greater risk of neonatal mortality (95% CI: 1.73–2.77, I2 = 33%). Among the subgroup of infants exclusively breastfed in the neonatal period, those who initiated breastfeeding ≥24 hours after birth had an 85% greater risk of neonatal mortality compared to infants who initiated <24 hours after birth (95% CI: 29–167%, I2 = 33%). Conclusions Policy frameworks and models to estimate newborn and infant survival, as well as health facility policies, should consider the potential independent effect of early breastfeeding initiation.
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Affiliation(s)
- Emily R. Smith
- Department of Global Health and Population, Harvard T. H. Chan School of Public Health, Boston, MA, United States of America
- * E-mail:
| | - Lisa Hurt
- Division of Population Medicine, Cardiff University School of Medicine, Wales, United Kingdom
| | - Ranadip Chowdhury
- Centre for Health Research and Development, Society for Applied Studies, New Delhi, India
| | - Bireshwar Sinha
- Centre for Health Research and Development, Society for Applied Studies, New Delhi, India
| | - Wafaie Fawzi
- Department of Global Health and Population, Harvard T. H. Chan School of Public Health, Boston, MA, United States of America
- Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA, United States of America
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, United States of America
| | - Karen M. Edmond
- School of Paediatrics and Child Health, University of Western Australia, Perth, Australia
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Acharya D, Singh JK, Adhikari M, Gautam S, Pandey P, Dayal V. Association of water handling and child feeding practice with childhood diarrhoea in rural community of Southern Nepal. J Infect Public Health 2017; 11:69-74. [PMID: 28576344 DOI: 10.1016/j.jiph.2017.04.007] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2016] [Revised: 03/15/2017] [Accepted: 04/28/2017] [Indexed: 11/18/2022] Open
Abstract
Diarrhoea is a major cause of childhood morbidity and mortality globally. While the childhood diarrhoea and its association with child feeding, and hygiene, hand washing and water treatment are studied elsewhere, the association of water handling and child feeding with childhood diarrhoea is an understudied area in Nepal. This study aimed to investigate the association of water handling and child feeding practice with childhood diarrhoea among children of one to five years of age in Southern, Nepal. A cross-sectional study was conducted in the Dhanusha district of Southern Nepal in 2013. A total of 284 mother-child pairs were selected using systemic random sampling. A four-week prevalence of childhood diarrhoea was reported using frequency distribution. The association of childhood diarrhoea with water handling and child feeding practices was ascertained using multiple logistic regressions after adjusting for potential confounders. The result of the study demonstrated that the four-week prevalence of childhood diarrhoea was 36.6%. Our finding showed that unsafe water handling practices were associated independently with childhood diarrhoea: untreated water (aOR 3.55; 95% CI: 1.13-11.10), uncovered water (aOR 2.14; 95% CI: 1.09-4.19). Similarly, partial breast feeding (aOR 4.35; 95% CI: 1.87-10.12) was also associated with higher odds of childhood diarrhoea. One third of children in Southern Nepal still had diarrhoea within the four weeks preceding the survey. As poor water handling and sub optimal infant feeding practice were major risk factors contributing to such a high burden of the disease, health promotion strategies such as promotion of safe water handling, improved hygiene and child feeding practices are recommended for the prevention of childhood diarrhoea in Southern Terai of Nepal.
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Affiliation(s)
- Dilaram Acharya
- Department of Community Medicine, Kathmandu University, Devdaha Medical College and Research Institute, Devdaha Municipality-10, Rupandehi, Nepal.
| | - Jitendra K Singh
- Department of Community Medicine & Public Health, Tribhuvan University, Janaki Medical College, Janakpur, Nepal; Department of Community Medicine, Institute of Medical Sciences, Banaras Hindu University, India.
| | | | - Salila Gautam
- Department of Public Health, Purbanchal University, Sanjeevani College of Medical Sciences, Butwal, Rupandehi, Nepal.
| | - Pragya Pandey
- Faculty of Nursing, Janaki Medical College, Tribhuvan University, Janakpur, Nepal.
| | - Vinita Dayal
- Population Services International, New Delhi, India.
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Al-Madani MM, Abu-Salem LY. Health Professionals' Perspectives on Breastfeeding Support Practices. SAUDI JOURNAL OF MEDICINE & MEDICAL SCIENCES 2017; 5:116-123. [PMID: 30787768 PMCID: PMC6298369 DOI: 10.4103/1658-631x.204875] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Background: The decrease in rates of exclusive breastfeeding has resulted in increased rates of infant mixed feeding. The WHO Baby-Friendly Hospital Initiative (BFHI) has been associated with significant increases in breastfeeding initiation and duration in maternity hospitals. However, little is known about whether or not the teaching hospital of the University of Dammam, Saudi Arabia, followed the ten steps recommended in the BFHI. Objectives: This study was carried out to assess healthcare professionals' perspectives and opinions about the breastfeeding support practices at the teaching hospital. Materials and Methods: This research is a mixed methodology cross-sectional study carried out in the King Fahd Hospital of the University, Al-Khobar, Saudi Arabia. The first phase used a self-administered questionnaire to assess professionals' awareness and opinions about actual breastfeeding practices. The first phase results led to a qualitative interview design for the second phase. Descriptive statistics were used to describe and summarize the data. The chi-square test was used to examine the difference between the observed and expected frequencies of normal data. Results: There were no breastfeeding supporting policies followed at the hospital as per those recommended by BFHI. Mothers with breastfeeding problems were not referred for help and follow-up phone calls were not made to postpartum women after discharge. Healthcare professionals indicated that there were no hospital-based breastfeeding support groups, lactation consultants/specialists or lactation management unit available. Conclusions: There is a need for breastfeeding support policies, practices and staff education to facilitate care consistent with the ten steps of the BFHI. Further study is needed to assess mothers' perspectives on breastfeeding approaches at the King Fahd Hospital of the University.
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Affiliation(s)
- Maha M Al-Madani
- Fundamentals of Nursing Department, College of Nursing, University of Dammam, Dammam, Saudi Arabia
| | - Laila Y Abu-Salem
- Fundamentals of Nursing Department, College of Nursing, University of Dammam, Dammam, Saudi Arabia
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Risk factors for prelacteal feeding in sub-Saharan Africa: a multilevel analysis of population data from twenty-two countries. Public Health Nutr 2017; 20:1953-1962. [PMID: 28443524 DOI: 10.1017/s1368980017000659] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To examine the risk factors of prelacteal feeding (PLF) among mothers in sub-Saharan Africa (SSA). DESIGN We pooled data from Demographic and Health Surveys in twenty-two SSA countries. The key outcome variable was PLF. A multilevel logistic regression model was used to explore factors associated with PLF. SETTING Demographic and Health Surveys in twenty-two SSA countries. SUBJECTS Mother-baby pairs (n 95348). RESULTS Prevalence of PLF in SSA was 32·2 %. Plain water (22·1 %), milk other than breast milk (5·0 %) and sugar or glucose water (4·1 %) were the predominant prelacteal feeds. In the multivariable analysis, mothers who had caesarean section delivery had 2·25 times the odds of giving prelacteal feeds compared with mothers who had spontaneous vaginal delivery (adjusted OR=2·25; 95 % CI 2·06, 2·46). Other factors that were significantly associated with increased likelihood of PLF were mother's lower educational status, first birth rank, fourth or above birth rank with preceding birth interval less than or equal to 24 months, lower number of antenatal care visits, home delivery, multiple birth, male infant, as well as having an average or small sized baby at birth. Mothers aged 20-34 years were less likely to give prelacteal feeds compared with mothers aged ≤19 years. Belonging to the second, middle or fourth wealth quintile was associated with lower likelihood of PLF compared with the highest quintile. CONCLUSIONS To achieve optimal breast-feeding, there is a need to discourage breast-feeding practices such as PLF. Breast-feeding promotion programmes should target the at-risk sub-population groups discovered in our study.
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Ogbo FA, Eastwood J, Page A, Arora A, McKenzie A, Jalaludin B, Tennant E, Miller E, Kohlhoff J, Noble J, Chaves K, Jones JM, Smoleniec J, Chay P, Smith B, Oei JL, Short K, Collie L, Kemp L, Raman S, Woolfenden S, Clark T, Blight V, Eapen V. Prevalence and determinants of cessation of exclusive breastfeeding in the early postnatal period in Sydney, Australia. Int Breastfeed J 2017; 12:16. [PMID: 28405212 PMCID: PMC5385049 DOI: 10.1186/s13006-017-0110-4] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2017] [Accepted: 03/27/2017] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND Optimal breastfeeding has benefits for the mother-infant dyads. This study investigated the prevalence and determinants of cessation of exclusive breastfeeding (EBF) in the early postnatal period in a culturally and linguistically diverse population in Sydney, New South Wales, Australia. METHODS The study used routinely collected perinatal data on all live births in 2014 (N = 17,564) in public health facilities in two Local Health Districts in Sydney, Australia. The prevalence of mother's breastfeeding intention, skin-to-skin contact, EBF at birth, discharge and early postnatal period (1-4 weeks postnatal) were estimated. Multivariate logistic regression models that adjusted for confounders were conducted to determine association between cessation of EBF in the early postnatal period and socio-demographic, psychosocial and health service factors. RESULTS Most mothers intended to breastfeed (92%), practiced skin-to-skin contact (81%), exclusively breastfed at delivery (90%) and discharge (89%). However, the prevalence of EBF declined (by 27%) at the early postnatal period (62%). Younger mothers (<20 years) and mothers who smoked cigarettes in pregnancy were more likely to cease EBF in the early postnatal period compared to older mothers (20-39 years) and those who reported not smoking cigarettes, respectively [Adjusted Odds Ratio (AOR) =2.7, 95%CI 1.9-3.8, P <0.001 and AOR = 2.5, 95%CI 2.1-3.0, P <0.001, respectively]. Intimate partner violence, assisted delivery, low socio-economic status, pre-existing maternal health problems and a lack of partner support were also associated with early cessation of EBF in the postnatal period. CONCLUSIONS Our findings suggest that while most mothers intend to breastfeed, and commence EBF at delivery and at discharge, the maintenance of EBF in the early postnatal period is sub-optimal. This highlights the need for efforts to promote breastfeeding in the wider community along with targeted actions for disadvantaged groups and those identified to be at risk of early cessation of EBF to maximise impact.
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Affiliation(s)
- Felix A. Ogbo
- Centre for Health Research, School of Medicine, Western Sydney University, Campbelltown Campus, Penrith, NSW Australia
- Ingham Institute for Applied Medical Research, Liverpool, NSW Australia
| | - John Eastwood
- Ingham Institute for Applied Medical Research, Liverpool, NSW Australia
- School of Women’s and Children’s Health, The University of New South Wales, Kensington, Sydney, NSW Australia
- Menzies Centre for Health Policy, Charles Perkins Centre, School of Public Health, Sydney University, Sydney, NSW Australia
- School of Public Health, Griffith University, Gold Coast, QLD Australia
- Department of Community Paediatrics, Sydney Local Health District, Croydon Community Health Centre, Croydon, NSW Australia
- Sydney Children’s Hospital Network, Randwick, NSW Australia
| | - Andrew Page
- Centre for Health Research, School of Medicine, Western Sydney University, Campbelltown Campus, Penrith, NSW Australia
- Ingham Institute for Applied Medical Research, Liverpool, NSW Australia
| | - Amit Arora
- Ingham Institute for Applied Medical Research, Liverpool, NSW Australia
- School of Science and Health, Western Sydney University, Campbelltown Campus, Penrith, NSW Australia
| | - Anne McKenzie
- Ingham Institute for Applied Medical Research, Liverpool, NSW Australia
- Child and Family Health Nursing, Primary & Community Health, South Western Sydney Local Health District, Narellan, NSW Australia
| | - Bin Jalaludin
- Ingham Institute for Applied Medical Research, Liverpool, NSW Australia
- Healthy People and Places Unit, South Western Sydney Local Health, Liverpool, NSW Australia
| | - Elaine Tennant
- Ingham Institute for Applied Medical Research, Liverpool, NSW Australia
- Department of Community Paediatrics, Sydney Local Health District, Croydon Community Health Centre, Croydon, NSW Australia
| | - Erin Miller
- Ingham Institute for Applied Medical Research, Liverpool, NSW Australia
- Department of Community Paediatrics, Sydney Local Health District, Croydon Community Health Centre, Croydon, NSW Australia
| | - Jane Kohlhoff
- Ingham Institute for Applied Medical Research, Liverpool, NSW Australia
- School of Psychiatry, UNSW Medicine, University of New South Wales, Randwick, NSW Australia
| | - Justine Noble
- Ingham Institute for Applied Medical Research, Liverpool, NSW Australia
- Department of Community Paediatrics, Sydney Local Health District, Croydon Community Health Centre, Croydon, NSW Australia
| | - Karina Chaves
- Ingham Institute for Applied Medical Research, Liverpool, NSW Australia
- Department of Community Paediatrics, Sydney Local Health District, Croydon Community Health Centre, Croydon, NSW Australia
| | - Jennifer M. Jones
- Ingham Institute for Applied Medical Research, Liverpool, NSW Australia
- Department of Community Paediatrics, Sydney Local Health District, Croydon Community Health Centre, Croydon, NSW Australia
| | - John Smoleniec
- Ingham Institute for Applied Medical Research, Liverpool, NSW Australia
- Women and Child Health, Liverpool Hospital, South Western Sydney Local Health District, Liverpool, NSW Australia
| | - Paul Chay
- Ingham Institute for Applied Medical Research, Liverpool, NSW Australia
- Peadiatrics and Neonatology, Liverpool Hospital, South Western Sydney Local Health District, Liverpool, NSW Australia
| | - Bronwyn Smith
- Ingham Institute for Applied Medical Research, Liverpool, NSW Australia
- Department of Community Paediatrics, Sydney Local Health District, Croydon Community Health Centre, Croydon, NSW Australia
| | - Ju-Lee Oei
- Ingham Institute for Applied Medical Research, Liverpool, NSW Australia
- Department of Newborn Care, Royal Hospital for Women, Randwick, NSW Australia
| | - Kate Short
- Ingham Institute for Applied Medical Research, Liverpool, NSW Australia
| | - Laura Collie
- Ingham Institute for Applied Medical Research, Liverpool, NSW Australia
- Department of Community Paediatrics, Sydney Local Health District, Croydon Community Health Centre, Croydon, NSW Australia
| | - Lynn Kemp
- Ingham Institute for Applied Medical Research, Liverpool, NSW Australia
- Translational Research and Social Innovation, School of Nursing and Midwifery, Western Sydney University, Penrith, NSW Australia
| | - Shanti Raman
- Ingham Institute for Applied Medical Research, Liverpool, NSW Australia
- Community Paediatrician for Child Protection, South Western Sydney Local Health District, Liverpool, NSW Australia
- Maari Ma Health Aboriginal Corporation, Broken Hill, NSW Australia
| | - Sue Woolfenden
- Ingham Institute for Applied Medical Research, Liverpool, NSW Australia
- School of Women’s and Children’s Health, The University of New South Wales, Kensington, Sydney, NSW Australia
- Department of Community Child Health/Integrated Care, Sydney Children’s Hospital Network, High Street, Randwick, NSW 2031 Australia
| | - Trish Clark
- Ingham Institute for Applied Medical Research, Liverpool, NSW Australia
- Child and Family Health Nursing, Primary & Community Health, South Western Sydney Local Health District, Narellan, NSW Australia
| | - Victoria Blight
- Ingham Institute for Applied Medical Research, Liverpool, NSW Australia
- Child and Family Health Nursing, Primary & Community Health, South Western Sydney Local Health District, Narellan, NSW Australia
| | - Valsamma Eapen
- Ingham Institute for Applied Medical Research, Liverpool, NSW Australia
- Academic Unit of Child Psychiatry, South West Sydney (AUCS), ICAMHS, Mental Health Centre, Liverpool Hospital, Liverpool, NSW Australia
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Raheem RA, Binns CW, Chih HJ. Protective effects of breastfeeding against acute respiratory tract infections and diarrhoea: Findings of a cohort study. J Paediatr Child Health 2017; 53:271-276. [PMID: 28134476 DOI: 10.1111/jpc.13480] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2016] [Revised: 07/12/2016] [Accepted: 12/04/2016] [Indexed: 01/30/2023]
Abstract
AIM The objective of this paper is to identify associations between breastfeeding and acute respiratory tract infections (ARTIs) and diarrhoea. METHODS A cohort of 458 mothers was recruited at the antenatal clinics at Indira Gandhi Memorial and Abdul Rahman Dhon Kaleyfaanu Hospitals. Mothers were interviewed 'face-to-face' at 36 weeks of gestation and at 1, 3 and 6 months after delivery. The questionnaires included demographic information about parents, infant feeding methods and breastfeeding duration. The number of episodes of ARTIs and diarrhoea was also recorded. Ethics approval was obtained from the National Research Committee of the Maldives and Curtin University Human Research Ethics Committee. Descriptive, univariate, logistic and survival analyses were used to assess the effects of breastfeeding on infant ARTIs and diarrhoea. RESULTS The partial, predominant and exclusive breastfeeding rates at 1 month were 98.9, 67.6 and 26.9%, respectively. The risk of acquiring ARTIs is significantly reduced when the infants were predominantly breastfed for 3 months (adjusted odds ratio (OR): 0.56, 95% of adjusted OR: 0.34-0.94) and 6 months (adjusted OR: 0.45, 95% of adjusted OR: 0.24-0.84). The risk of getting diarrhoea is significantly reduced even when the babies were partially breastfed for 6 months (adjusted OR): 0.31, 95% of adjusted OR: 0.11-0.90). Kaplan Meier curves demonstrated that the risk lowers with longer duration of breastfeeding. CONCLUSION Breastfeeding need to be promoted because the risk of infant morbidity is negatively associated with the duration of breastfeeding.
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Affiliation(s)
| | - Colin W Binns
- School of Public Health, Curtin University, Perth, Western Australia, Australia
| | - Hui J Chih
- School of Public Health, Curtin University, Perth, Western Australia, Australia
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Ogbo FA, Agho K, Ogeleka P, Woolfenden S, Page A, Eastwood J. Infant feeding practices and diarrhoea in sub-Saharan African countries with high diarrhoea mortality. PLoS One 2017; 12:e0171792. [PMID: 28192518 PMCID: PMC5305225 DOI: 10.1371/journal.pone.0171792] [Citation(s) in RCA: 76] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2016] [Accepted: 01/25/2017] [Indexed: 11/05/2022] Open
Abstract
Background The impacts of optimal infant feeding practices on diarrhoea have been documented in some developing countries, but not in countries with high diarrhoea mortality as reported by the World Health Organisation/United Nations Children’s Fund. We aimed to investigate the association between infant feeding practices and diarrhoea in sub-Saharan African countries with high diarrhoea mortality. Method The study used the most recent Demographic and Health Survey datasets collected in nine sub-Saharan African countries with high diarrhoea mortality, namely: Burkina Faso (2010, N = 9,733); Demographic Republic of Congo (2013; N = 10,458); Ethiopia (2013, N = 7,251); Kenya (2014, N = 14,034); Mali (2013, N = 6,365); Niger (2013, N = 7,235); Nigeria (2013, N = 18,539); Tanzania (2010, N = 5,013); and Uganda (2010, N = 4,472). Multilevel logistic regression models that adjusted for cluster and sampling weights were used to investigate the association between infant feeding practices and diarrhoea in these nine African countries. Results Diarrhoea prevalence was lower among children whose mothers practiced early initiation of breastfeeding, exclusive and predominant breastfeeding. Early initiation of breastfeeding and exclusive breastfeeding were significantly associated with lower risk of diarrhoea (OR = 0.81; 95% confidence interval (CI): 0.77–0.85, P<0.001 and OR = 0.50; 95%CI: 0.43–0.57, respectively). In contrast, introduction of complementary foods (OR = 1.31; 95%CI: 1.14–1.50) and continued breastfeeding at one year (OR = 1.27; 95%CI: 1.05–1.55) were significantly associated with a higher risk of diarrhoea. Conclusion Early initiation of breastfeeding and exclusive breastfeeding are protective of diarrhoea in sub-Saharan African countries with high diarrhoea mortality. To reduce diarrhoea mortality and also achieve the health-related sustainable development goals in sub-Saharan African, an integrated, multi-agency strategic partnership within each country is needed to improve optimal infant feeding practices.
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Affiliation(s)
- Felix A. Ogbo
- Centre for Health Research, School of Medicine, Western Sydney University, Campbelltown Campus, New South Wales, Australia
- Ingham Institute for Applied Medical Research, Liverpool, New South Wales, Australia
- * E-mail:
| | - Kingsley Agho
- School of Science and Health, Western Sydney University, Campbelltown Campus, New South Wales, Australia
| | - Pascal Ogeleka
- Department of Public Health, College of Science, School of Public Health, Health and Engineering, La Trobe University, Bundoora, Victoria, Australia
| | - Sue Woolfenden
- Ingham Institute for Applied Medical Research, Liverpool, New South Wales, Australia
- Department of Community Child Health/Integrated Care, Sydney Children’s Hospital Network, Randwick, New South Wales, Australia
- School of Women’s and Children’s Health, The University of New South Wales, Kensington, Sydney, New South Wales, Australia
| | - Andrew Page
- Centre for Health Research, School of Medicine, Western Sydney University, Campbelltown Campus, New South Wales, Australia
- Ingham Institute for Applied Medical Research, Liverpool, New South Wales, Australia
| | - John Eastwood
- Ingham Institute for Applied Medical Research, Liverpool, New South Wales, Australia
- School of Women’s and Children’s Health, The University of New South Wales, Kensington, Sydney, New South Wales, Australia
- Menzies Centre for Health Policy, Charles Perkins Centre, School of Public Health, Sydney University, Sydney, New South Wales, Australia
- School of Public Health, Griffith University, Gold Coast, Queensland, Australia
- Department of Community Paediatrics, Sydney Local Health District, Croydon Community Health Centre, Croydon, New South Wales, Australia
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Ogbo FA, Page A, Idoko J, Claudio F, Agho KE. Diarrhoea and Suboptimal Feeding Practices in Nigeria: Evidence from the National Household Surveys. Paediatr Perinat Epidemiol 2016; 30:346-55. [PMID: 27009844 DOI: 10.1111/ppe.12293] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Globally, Nigeria has the largest burden of infectious diseases (including diarrhoea). Optimal feeding practices have been well-documented to protect against diarrhoea in other contexts; but this benefit has not been broadly studied in Nigeria. The study aimed to examine the association between diarrhoea and childhood feeding practices to provide country-specific evidence. METHOD Data from the Nigeria Demographic and Health Survey for the period spanning 1999-2013 were used. Prevalence of diarrhoea by infant and young child feeding indicators was estimated, and the association between diarrhoea and childhood feeding indicators was examined using multilevel regression analyses. RESULTS Prevalence of diarrhoea was higher among children whose mothers did not initiate breast feeding within the first hour of birth, infants who were not exclusively breastfed, and infants who were prematurely introduced to complementary foods. Early initiation of breast feeding was significantly associated with lower risk of diarrhoea (RR 0.68, 95% confidence interval (CI) 0.63, 0.74). Exclusively breastfed infants were less likely to develop diarrhoea compared to non-exclusively breastfed infants (RR 0.61, 95% CI 0.44, 0.86). Predominant breast feeding was significantly associated with a lower risk of diarrhoea (RR 0.66, 95% CI 0.54, 0.80). Bottle feeding and introduction of complementary foods were associated with a higher risk of diarrhoea. CONCLUSION Early initiation of breast feeding as well as exclusive and predominant breast feeding protect against diarrhoea in Nigeria, while bottle feeding and introduction of complementary foods were risk factors for diarrhoea. Community- and facility-based initiatives are needed to improve feeding practices, and to reduce diarrhoea prevalence in Nigeria.
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Affiliation(s)
- Felix A Ogbo
- Centre for Health Research, School of Medicine, Western Sydney University, Penrith, NSW, Australia
| | - Andrew Page
- Centre for Health Research, School of Medicine, Western Sydney University, Penrith, NSW, Australia
| | - John Idoko
- Office of the Director General, National Agency for the Control of AIDS, Abuja, FCT, Nigeria
| | - Fernanda Claudio
- School of Medicine, The University of Queensland, Brisbane, QLD, Australia
| | - Kingsley E Agho
- School of Science and Health, Western Sydney University, Penrith, NSW, Australia
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Liben ML, Yesuf EM. Determinants of early initiation of breastfeeding in Amibara district, Northeastern Ethiopia: a community based cross-sectional study. Int Breastfeed J 2016; 11:7. [PMID: 27064535 PMCID: PMC4826535 DOI: 10.1186/s13006-016-0067-8] [Citation(s) in RCA: 58] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2015] [Accepted: 04/03/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Early initiation of breastfeeding has lifetime benefits for the mother and the child. It has a positive impact on the duration of exclusive breastfeeding. Hence, the initiation of breastfeeding within the first hour of life lays the foundation for optimal breastfeeding. This study aimed to assess early and timely initiation of breastfeeding practices and associated factors among mothers of children aged less than 24 months in Amibara district of Northeast Ethiopia during April 2015. METHODS A quantitative community based cross-sectional study was employed on 407 mothers of children aged less than 24 months in Amibara district. Descriptive statistics, binary and multivariable logistic regression analysis were employed to identify the factors associated with early initiation of breastfeeding. The strength of the association was measured by odds ratio, and p-value < 0.05 was considered statistically significant. RESULTS Three hundred eighty one (94.5 %) of the respondents had ever breastfed their index child. Of those who had ever breastfed, 151, 39.6 % (95 % Confidence Interval [CI] 35.0 %, 45.0 %) of mothers initiated breastfeeding within 1 h after birth. In multivariable logistic regression analysis mothers living in urban areas (Adjusted Odds Ratio [AOR] 3.8; 95 % CI 2.32, 6.06) and who attended formal education (AOR 2.0; 95 % CI 1.21, 3.46) were associated with increased odds of early initiation of breastfeeding. The factors associated with decreased odds of timely initiation of breastfeeding were caesarean section delivery (AOR 0.46; 95 % CI 0.22, 0.97) and mothers with two or three children (AOR 0.59; 95 % CI 0.35, 0.99). CONCLUSION This study showed that four in ten infants were breastfed within the first hour after birth. Therefore, providing proper support and guidance of health professionals during cesarean section delivery and breastfeeding education programs at the village level for girls and young women without formal education are important interventions to promote early initiation of breastfeeding in the study area.
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Affiliation(s)
- Misgan Legesse Liben
- Department of Public Health, College of Medical and Health Sciences, Samara University, Samara, Afar Ethiopia
| | - Ebrahim Mohammed Yesuf
- Department of Public Health, College of Medical and Health Sciences, Samara University, Samara, Afar Ethiopia
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Liben ML, Gemechu YB, Adugnew M, Asrade A, Adamie B, Gebremedin E, Melak Y. Factors associated with exclusive breastfeeding practices among mothers in dubti town, afar regional state, northeast Ethiopia: a community based cross-sectional study. Int Breastfeed J 2016; 11:4. [PMID: 26997971 PMCID: PMC4797331 DOI: 10.1186/s13006-016-0064-y] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2015] [Accepted: 03/14/2016] [Indexed: 11/16/2022] Open
Abstract
Background Exclusive breastfeeding for the first 6 months of life is recommended internationally. This study aimed to investigate exclusive breastfeeding practices and associated factors among mothers of infants aged less than 6 months. Methods A community based cross-sectional study was conducted on mother-infant pairs in Dubti town in May, 2015. In this study, exclusive breastfeeding was defined as an infant’s breast milk consumption without supplementation of any type of food or drink, except for vitamins, minerals and necessary medications in the 24 h preceding the survey. Descriptive statistics, bivariate and multivariable logistic regression analysis were employed to identify the factors associated with exclusive breastfeeding practices. Variables with a p-value < 0.05 in the multivariable model were identified as predictors of exclusive breastfeeding practices. Results Exclusive breastfeeding under 6 months was practiced by 81.1 % (95 % Confidence Interval [CI] 77.0, 85.0 %) of mothers of infants aged less than 6 months. The median duration of exclusive breastfeeding for infants less than 6 months was 3 months. Multivariable logistic regression analysis showed that initiation of breastfeeding within 1 h after birth (Adjusted Odds Ratio [AOR] 5.46; 95 % CI 1.93, 15.41), age of infants of less than 2 months (AOR 7.03; 95 % CI 2.16, 22.88), being a housewife (AOR 4.81; 95 % CI 2.30, 10.06) and mothers who received postnatal counseling (AOR 3.88; 95 % CI 1.88, 7.99) were positive predictors of exclusive breastfeeding. Conclusion The study revealed that exclusive breastfeeding under 6 months using 24-h recall method was lower than the World Health Organization recommendation. Therefore, interventions could focus on educating mothers the importance of timely initiation of breastfeeding and postnatal care in the study area.
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Affiliation(s)
- Misgan Legesse Liben
- Department of Public Health, College of Medical and Health Sciences, Samara University, Afar, Ethiopia
| | - Yohannes Bacha Gemechu
- Department of Nursing, College of Medical and Health Sciences, Samara University, Afar, Ethiopia
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Bui QTT, Lee HY, Le ATK, Van Dung D, Vu LTH. Trends and determinants for early initiation of and exclusive breastfeeding under six months in Vietnam: results from the Multiple Indicator Cluster Surveys, 2000-2011. Glob Health Action 2016; 9:29433. [PMID: 26950562 PMCID: PMC4780108 DOI: 10.3402/gha.v9.29433] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2015] [Revised: 11/22/2015] [Accepted: 11/27/2015] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND There is strong evidence that breastfeeding (BF) significantly benefits mothers and infants in various ways. Yet the proportion of breastfed babies in Vietnam is low and continues to decline. This study fills an important evidence gap in BF practices in Vietnam. OBJECTIVE This paper examines the trend of early initiation of BF and exclusive BF from 2000 to 2011 in Vietnam and explores the determinants at individual and contextual levels. DESIGN Data from three waves of the Multiple Indicator Cluster Survey were combined to estimate crude and adjusted trends over time for two outcomes - early initiation of BF and exclusive BF. Three-level logistic regressions were fitted to examine the impacts of both individual and contextual characteristics on early initiation of BF and exclusive BF in the 2011 data. RESULTS Both types of BF showed a decreasing trend over time after controlling for individual-level characteristics but this trend was more evident for early initiation of BF. Apart from child's age, individual-level characteristics were not significant predictors of the BF outcomes, but provincial characteristics had a strong association. When controlling for individual-level characteristics, mothers living in provinces with a higher percentage of mothers with more than three children were more likely to have initiated early BF (odds ratio [OR]: 1.06; confidence interval [CI]: 1.02-1.11) but less likely to exclusively breastfeed their babies (OR: 0.94; CI: 0.88-1.01). Mothers living in areas with a higher poverty rate were more likely to breastfeed exclusively (OR: 1.07; CI: 1.02-1.13), and those who delivered by Caesarean section were less likely to initiate early BF. CONCLUSIONS Our results suggest that environmental factors are becoming more important for determining BF practices in Vietnam. Intervention programs should therefore not only consider individual factors, but should also consider the potential impact of contextual factors on BF practices.
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Affiliation(s)
- Quyen Thi-Tu Bui
- Department of Epidemiology and Biostatistics, The Hanoi School of Public Health, Hanoi, Vietnam;
| | - Hwa-Young Lee
- JW Lee Center for Global Medicine, Seoul National University College of Medicine, Seoul, South Korea; ;
| | - Anh Thi-Kim Le
- Department of Epidemiology and Biostatistics, The Hanoi School of Public Health, Hanoi, Vietnam
| | - Do Van Dung
- Ho Chi Minh City University of Medicine and Pharmacy, Ho Chi Minh City, Vietnam
| | - Lan Thi-Hoang Vu
- Department of Epidemiology and Biostatistics, The Hanoi School of Public Health, Hanoi, Vietnam
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Patel A, Bucher S, Pusdekar Y, Esamai F, Krebs NF, Goudar SS, Chomba E, Garces A, Pasha O, Saleem S, Kodkany BS, Liechty EA, Kodkany B, Derman RJ, Carlo WA, Hambidge K, Goldenberg RL, Althabe F, Berrueta M, Moore JL, McClure EM, Koso-Thomas M, Hibberd PL. Rates and determinants of early initiation of breastfeeding and exclusive breast feeding at 42 days postnatal in six low and middle-income countries: A prospective cohort study. Reprod Health 2015; 12 Suppl 2:S10. [PMID: 26063291 PMCID: PMC4464210 DOI: 10.1186/1742-4755-12-s2-s10] [Citation(s) in RCA: 68] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background Early initiation of breastfeeding after birth and exclusive breastfeeding through six months of age confers many health benefits for infants; both are crucial high impact, low-cost interventions. However, determining accurate global rates of these crucial activities has been challenging. We use population-based data to describe: (1) rates of early initiation of breastfeeding (defined as within 1 hour of birth) and of exclusive breastfeeding at 42 days post-partum; and (2) factors associated with failure to initiate early breastfeeding and exclusive breastfeeding at 42 days post-partum. Methods Prospectively collected data from women and their live-born infants enrolled in the Global Network’s Maternal and Newborn Health Registry between January 1, 2010-December 31, 2013 included women-infant dyads in 106 geographic areas (clusters) at 7 research sites in 6 countries (Kenya, Zambia, India [2 sites], Pakistan, Argentina and Guatemala). Rates and risk factors for failure to initiate early breastfeeding were investigated for the entire cohort and rates and risk factors for failure to maintain exclusive breastfeeding was assessed in a sub-sample studied at 42 days post-partum. Result A total of 255,495 live-born women-infant dyads were included in the study. Rates and determinants for the exclusive breastfeeding sub-study at 42 days post-partum were assessed from among a sub-sample of 105,563 subjects. Although there was heterogeneity by site, and early initiation of breastfeeding after delivery was high, the Pakistan site had the lowest rates of early initiation of breastfeeding. The Pakistan site also had the highest rate of lack of exclusive breastfeeding at 42 days post-partum. Across all regions, factors associated with failure to initiate early breastfeeding included nulliparity, caesarean section, low birth weight, resuscitation with bag and mask, and failure to place baby on the mother’s chest after delivery. Factors associated with failure to achieve exclusive breastfeeding at 42 days varied across the sites. The only factor significant in all sites was multiple gestation. Conclusions In this large, prospective, population-based, observational study, rates of both early initiation of breastfeeding and exclusive breastfeeding at 42 days post-partum were high, except in Pakistan. Factors associated with these key breastfeeding indicators should assist with more effective strategies to scale-up these crucial public health interventions. Trial registration Registration at the Clinicaltrials.gov website (ID# NCT01073475).
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Legesse M, Demena M, Mesfin F, Haile D. Prelacteal feeding practices and associated factors among mothers of children aged less than 24 months in Raya Kobo district, North Eastern Ethiopia: a cross-sectional study. Int Breastfeed J 2014; 9:189. [PMID: 25648571 PMCID: PMC4308855 DOI: 10.1186/s13006-014-0025-2] [Citation(s) in RCA: 63] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2014] [Accepted: 12/07/2014] [Indexed: 11/10/2022] Open
Abstract
Background The harmful infant feeding practices of prelacteal feeding is widely practiced in Ethiopia. Hence, it is vital to appreciate the cultural basis and potential factors on infant feeding practices in different parts of Ethiopia. This study aimed to investigate prelacteal feeding practices and associated factors among mothers of children aged less than 24 months in Raya Kobo district, North Eastern Ethiopia. Methods A quantitative community-based cross-sectional study supplemented by qualitative methods was employed. Sixty hundred thirty (630) mothers of children aged less than 24 months were selected by systematic random sampling technique. Descriptive statistics, bivariate and multivariable logistic regression analysis were employed to identify the factors associated with prelacteal feeding practices. Variables with a p-value < 0.05 were identified as statistically significant factors. Qualitative data was collected by focus group discussion and in-depth interview and analyzed using thematic frameworks. Results The prevalence of prelacteal feeding was 38.8% (95% CI: 35.00%, 43.00%). Home delivery was a risk factor for practicing prelacteal feeding. Those mothers who gave birth at home were seven times more likely to practice prelacteal feeding as compared to mothers who delivered at health institutions (Adjusted Odd Ratio (AOR):7.10; 95% CI: 3.91, 12.98). Mothers who were not aware of the risks associated with prelacteal feeding were nearly four times more likely to practice prelacteal feeding as compared to knowledgeable mothers (AOR: 3.70; 95% CI: 2.44, 5.53). Late initiation of breastfeeding (after one hour of delivery) was also associated with prelacteal feeding practice (AOR: 2.70; 95% CI: 1.78, 3.99). The major reasons stated for providing prelacteal feeding were to prevent “evil eye” and illness and to “clean infant’s stomach”. Conclusion Prelacteal feeding was commonly practiced in Raya Kobo district. Home delivery, delayed commencement of breastfeeding after birth and lack of awareness about the risks associated with prelacteal feeding were predictors of prelacteal feeding. Therefore, strengthening infant feeding counseling about the risks associated with prelacteal feeding, promoting institutional delivery and timely initiation of breastfeeding are important measures for preventing prelacteal feeding in Raya Kobo district.
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Affiliation(s)
- Misgan Legesse
- Department of Nursing, College of Medicine and Health Sciences, Samara University, Samara, Ethiopia
| | - Melake Demena
- Department of Public Health, College of Health Science and Medicine, Haramaya University, Harar, Ethiopia
| | - Firehiwot Mesfin
- Department of Public Health, College of Health Science and Medicine, Haramaya University, Harar, Ethiopia
| | - Demewoz Haile
- Department of Public Health, College of Medicine and Health Sciences, Madawalabu University, Bale Goba, Ethiopia
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