Influence of sociodemographic and psychosocial characteristics on breastfeeding duration of mothers attending breastfeeding support groups

Relationship between Maternal Postpartum Intention to Breastfeed and Actual Breastfeeding Duration - Four Provinces, China, 2015-2017

What is already known about this topic?

Several studies have reported that maternal antenatal intention to breastfeed is a strong predictor of actual breastfeeding duration. However, little research has investigated whether maternal postpartum intention also extends breastfeeding duration.

What is added by this report?

Maternal postpartum intention to breastfeed was a protective factor for extending actual breastfeeding duration after controlling potential confounders.

What are the implications for public health practice?

It is crucial to address and promote intrinsic and extrinsic factors that influence a mother's intention to breastfeed after delivery, thereby extending the actual breastfeeding duration.

A behavioral economic demand analysis of mothers' decision to exclusively breastfeed in the workplace

The present study determined whether behavioral economic demand analysis could characterize mothers' decision to exclusively breastfeed in the workplace. Females, aged between 18 and 50 who have given birth in the past three years, completed a novel demand task with hypothetical scenarios, in which they returned to work with a 2-month-old baby. Participants rated their likelihood of breastfeeding their baby at a workplace lactation room versus formula-feeding their baby at their desk. The distance to the lactation room ranged from 10 s to 60 min. This assessment was conducted with and without hypothetical financial incentives for 6-month exclusive breastfeeding. Primary dependent measures were demand intensity and change in demand elasticity, which could conceptually represent initiation and continuation of breastfeeding, respectively. Demand for breastfeeding was more intense and less elastic (i.e., more likely to initiate and continue breastfeeding) among mothers with an experience of 6-month exclusive breastfeeding and under the condition with the financial incentives. The novel demand task can potentially provide a useful behavioral marker for quantifying mothers' decision to initiate and continue exclusive breastfeeding in the workplace, informing workplace policy regarding lactation rooms, identifying risk for early cessation, and developing and individualizing an intervention to assist mothers to exclusively breastfeed in the workplace.

Infant Feeding Practices in China and Ireland: Ireland Chinese Mother Survey

Introduction: Migration to another country may induce changes in infant feeding practices especially where such practices differ considerably between the two countries. This study was undertaken to compare the infant feeding practices between Chinese mothers who gave birth in Ireland (CMI) with immigrant Chinese mothers who gave birth in China (CMC), and to examine the factors that influence these practices.

Methods: A cross-sectional self-administrated survey was conducted among a convenience sample of 322 Chinese mothers living in Ireland. Data were obtained from mailed questionnaires. Infant feeding practices between CMC and CMI were compared by Chi-square or independent sample t-test. Binary logistic regression analyses were further performed to test the differences in infant feeding practices between two groups, after controlling for potential socio-demographic confounders.

Results: High breastfeeding initiation rates were found in both groups (CMC: 87.2%; CMI: 75.6%); however sharp reductions in breastfeeding rates at 3 months (49.1%) and 6 months (28.4%) were found among CMI but not CMC (P < 0.05). Introduction of water within 1 week after childbirth was common for CMC in comparison with CMI. CMI were more likely than CMC to introduce infant formula to their child within the first 4 months after childbirth. The timing of introduction of rice porridge, vegetables, fruits and meats did not differ between CMC and CMI.

Conclusions: Cultural and perceptional factors, and changes caused by migration contribute to the decline in breastfeeding duration among CMI. Language-specific breastfeeding support and education among Chinese mothers in Ireland is needed, in particular to encourage mothers to breastfeed for 6 months or more.

Does exclusive breastfeeding relate to the longer duration of breastfeeding? A prospective cohort study

OBJECTIVES

Suboptimal breastfeeding contributes to morbidity and mortality in children. Studies in high-income countries (HICs) show that exclusive-breastfeeding (EBF) is associated with longer breastfeeding duration. The aim of this study was to determine whether maternal reports of EBF at six months are associated with longer duration of breastfeeding during the first two years of life in a low and middle-income country (LMIC) setting, and to identify determinants of breastfeeding duration.

METHODS

This prospective cohort includes data from an EBF promotion program in Demak District, Central Java Province, Indonesia, with a non-randomized pretest-posttest control group. Mothers and infants were followed through 26 months postnatal age. Data were analyzed using Cox proportional hazard regression with time to cessation of EBF as the outcome.

RESULTS

A total of 147 families were included in the study. Longer EBF duration was not associated with prolonged duration of breastfeeding. Longer breastfeeding duration was associated with mothers who disagreed with a statement of being ashamed to breastfeed (HR 0.035, 95%CI 0.003,0.44). Risk factors for shorter breastfeeding duration included mothers' plan to breastfeed for less than 24 months (HR 4.28 95%CI 1.91,9.60), mothers' belief that breastfeeding less than 24 months was the norm (HR 2.98 95%CI 1.31,6.77) and exposure to EBF promotion (HR:4.09 95%CI 2.14,7.82).

CONCLUSIONS

In a LMIC community where long breastfeeding duration is common, EBF is not associated with breastfeeding duration. However, modifiable behavioral factors were significant predictors of breastfeeding duration. We therefore recommend that prolonged breastfeeding duration can be achieved through programs that improve breastfeeding behavior.

BReastfeeding Attitude and Volume Optimization (BRAVO) trial: study protocol for a randomized controlled trial

BACKGROUND

A growing body of evidence shows the short-term benefits of breastfeeding, which include protection against infections, allergies, and lung diseases. However, evidence on the long-term benefits of breastfeeding is scarce and often conflicting. The BReastfeeding Attitude and Volume Optimization (BRAVO) trial is designed to study the effect of breastfeeding on early signs of later chronic diseases, particularly cardiovascular, respiratory, and metabolic risks later in life. In addition, the effectiveness of breastfeeding empowerment in promoting breastfeeding will also be evaluated.

METHODS/DESIGN

This study is an ongoing randomized trial in Jakarta, Indonesia, that began in July 2012. Pregnant women are being screened for their breastfeeding plan in the third trimester, and those with low intention to breastfeed are randomly allocated to either receiving an add-on breastfeeding-optimization program or usual care. Primary outcomes include breastfeeding rate, lung function, and blood pressure during the first year of life and vascular/cardiac characteristics, which will be measured at the age of 4 to 5 years. Child growth and infection/illness episodes are measured, whereas cognitive testing is planned for the children at 5 years of age.

DISCUSSION

To date, 784 women (80 %) have been randomized of the 1,000 planned, with satisfactory completeness of the 1-year follow up (90.1 %). Included mothers are of lower socioeconomic status and more often have blue-collar jobs, similar to what was observed in the pilot study.

TRIAL REGISTRATION

ClinicalTrials.gov, NCT01566812 . Registered on 27 March 2012.

Relationship between participation in leisure activities and constraints on Taiwanese breastfeeding mothers during leisure activities

Background

Participation in leisure activities strongly associates with health and well-being. Little research has explored the relationship between participation in leisure activities and constraints on breastfeeding mothers during leisure activities. The purposes of this study are: 1) to investigate constraints on breastfeeding mothers during leisure activities and participation in leisure activities; 2) to investigate the differences between preferences for leisure activities and actual participation by breastfeeding mothers; 3) to segment breastfeeding mothers with similar patterns, using a cluster analysis based on the delineated participation in leisure activities and leisure preferences; 4) to explore any differences between clusters of breastfeeding mothers with respect to socio-demographic characteristics, breastfeeding behaviours and leisure constraints.

Methods

This study has a cross-sectional design using an online survey conducted among mothers having breastfeeding experiences of more than four months. The questionnaire includes demographic variables, breastfeeding behaviours, preferences for leisure activities participation, and constraints on leisure activities. Collection of data occurred between March and July 2011, producing 415 valid responses for analysis.

Results

For breastfeeding mothers, this study identifies constraints on breastfeeding related to leisure activities in addition to the three traditional factors for constraints in the model. This study demonstrates that reports of constraints related to children, family, and nursing environments are the most frequent. Breastfeeding mothers in Taiwan participate regularly in family activities or activities related to their children. Cluster analysis classified breastfeeding mothers into Action and Contemplation groups, and found that mothers within the latter group participate less in leisure activities and experienced more constraints related to breastfeeding.

Conclusions

Implications provide a developmental design for public health policies for nursing-friendly environments to increase opportunities for breastfeeding mothers to engage in leisure activities and suggest various types of activities to increase participation of that population.

Breastfeeding attitudes of Finnish parents during pregnancy

BACKGROUND

Breastfeeding attitudes are known to influence infant feeding but little information exists on the prenatal breastfeeding attitudes of parents. The purpose of this study was to describe Finnish parents' prenatal breastfeeding attitudes and their relationships with demographic characteristics.

METHODS

The electronic Breastfeeding Knowledge, Attitude and Confidence scale was developed and 172 people (123 mothers, 49 fathers) completed the study. The data were analysed using factor analysis and nonparametric methods.

RESULTS

Breastfeeding was regarded as important, but 54% of the respondents wanted both parents to feed the newborn. The mean rank values of breastfeeding attitudes differed significantly when parity, gender, education, age, breastfeeding history and level of breastfeeding knowledge were considered. The respondents who were expecting their first child, were 18-26 years old or had vocational qualifications or moderate breastfeeding knowledge had more negative feelings and were more worried about breastfeeding than respondents who had at least one child, had a higher vocational diploma or academic degree or had high levels of breastfeeding knowledge. Respondents with high levels of breastfeeding knowledge did not appear concerned about equality in feeding.

CONCLUSIONS

Both mothers and fathers found breastfeeding important. A father's eagerness to participate in their newborn's life should be included in prenatal breastfeeding counselling and ways in which to support breastfeeding discussed. Relevant information about breastfeeding should focus on the parents who are expecting their first child, those who are young, those with low levels of education or those who have gaps in breastfeeding knowledge, so that fears and negative views can be resolved.

Overcoming barriers to breastfeeding continuation and exclusivity

PURPOSE OF REVIEW

To review recent research that delineates predictors of breastfeeding duration and exclusivity.

RECENT FINDINGS

Many mothers find it difficult to meet personal goals and follow expert recommendations for continued and exclusive breastfeeding despite increased rates of initiation. Recent studies have revealed varied sociodemographic, biomedical, and psychosocial determinants of breastfeeding duration and exclusivity.

SUMMARY

In order to help mothers meet personal goals and expert recommendations for breastfeeding, pediatricians should educate themselves regarding predictors of and barriers to successful breastfeeding. Once these predictors and barriers have been identified, targeted anticipatory guidance can be provided to help mothers achieve breastfeeding success.