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Beaudry M, Bustinza R, Michaud-Létourneau I. Alimentation infantile et changements climatiques : une opportunité prometteuse. CANADIAN JOURNAL OF PUBLIC HEALTH = REVUE CANADIENNE DE SANTE PUBLIQUE 2024; 115:477-481. [PMID: 38526809 PMCID: PMC11151884 DOI: 10.17269/s41997-024-00869-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Accepted: 02/12/2024] [Indexed: 03/27/2024]
Abstract
The method of infant feeding has consequences for the production of greenhouse gases (GHG) as well as for the risks to infants posed by climate change. Breastfeeding can reduce the carbon footprint associated with the use of commercial infant formula by nearly 50% while reducing its water footprint and waste. It is also an excellent way of coping with emergencies associated with climate change, such as water shortages, since breastfed children are better protected than those fed with formula. To ensure that the protection offered by breastfeeding can be realized, we present elements that can help decision-makers seize a promising opportunity: improve infant feeding support for women and families.
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Affiliation(s)
| | - Ray Bustinza
- Institut national de santé publique du Québec, Québec, Québec, Canada
| | - Isabelle Michaud-Létourneau
- Mouvement allaitement du Québec, Montréal, Québec, Canada
- Département de médecine sociale et préventive, École de santé publique de l'Université de Montréal, Montréal, Québec, Canada
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Conway F, Portela A, Filippi V, Chou D, Kovats S. Climate change, air pollution and maternal and newborn health: An overview of reviews of health outcomes. J Glob Health 2024; 14:04128. [PMID: 38785109 PMCID: PMC11117177 DOI: 10.7189/jogh.14.04128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2024] Open
Abstract
Background Climate change represents a fundamental threat to human health, with pregnant women and newborns being more susceptible than other populations. In this review, we aimed to describe the current landscape of available epidemiological evidence on key climate risks on maternal and newborn health (MNH). Methods We sought to identify published systematic and scoping reviews investigating the impact of different climate hazards and air pollution on MNH outcomes. With this in mind, we developed a systematic search strategy based on the concepts of 'climate/air pollution hazards, 'maternal health,' and 'newborn health,' with restrictions to reviews published between 1 January 2010 and 6 February 2023, but without geographical or language restriction. Following full text screening and data extraction, we synthesised the results using narrative synthesis. Results We found 79 reviews investigating the effects of climate hazards on MNH, mainly focussing on outdoor air pollution (n = 47, 59%), heat (n = 24, 30%), and flood/storm disasters (n = 7, 9%). Most were published after 2015 (n = 60, 76%). These reviews had consistent findings regarding the positive association of exposure to heat and to air pollution with adverse birth outcomes, particularly preterm birth. We found limited evidence for impacts of climate-related food and water security on MNH and did not identify any reviews on climate-sensitive infectious diseases and MNH. Conclusions Climate change could undermine recent improvements in maternal and newborn health. Our review provides an overview of key climate risks to MNH. It could therefore be useful to the MNH community to better understand the MNH needs for each climate hazard and to strengthen discussions on evidence and research gaps and potential actions. Despite the lack of comprehensive evidence for some climate hazards and for many maternal, perinatal, and newborn outcomes, we observed repeated findings of the impact of heat and air pollutants on birth outcomes, particularly preterm birth. It is time for policy dialogue to follow to specifically design climate policy and actions to protect the needs of MNH.
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Affiliation(s)
- Francesca Conway
- World Health Organization, Department of Maternal, Newborn, Child and Adolescent Health and Ageing, Geneva, Switzerland
| | - Anayda Portela
- World Health Organization, Department of Maternal, Newborn, Child and Adolescent Health and Ageing, Geneva, Switzerland
| | - Veronique Filippi
- London School of Hygiene and Tropical Medicine, Faculty of Epidemiology and Population Health, London, United Kingdom
| | - Doris Chou
- UNDP/UNFPA/UNICEF/WHO/The World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), World Health Organization, Department of Sexual and Reproductive Health, Geneva, Switzerland
| | - Sari Kovats
- London School of Hygiene and Tropical Medicine, NIHR Health Protection Research Unit in Environmental Change and Health, London, United Kingdom
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Negesse A, Girma T, Desalegn BB, Kerac M, Berhane M. The epidemiology and associated factors of non-exclusive breastfeeding: a comparative cross-sectional study of livelihood-secure and insecure areas. Front Nutr 2024; 11:1347780. [PMID: 38826580 PMCID: PMC11141399 DOI: 10.3389/fnut.2024.1347780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Accepted: 04/29/2024] [Indexed: 06/04/2024] Open
Abstract
Introduction Regardless of national commitment, non-exclusive breastfeeding (NEBF) is a public health problem that worsens over time. It can be associated with sociodemographic, economic, and environmental factors and may vary depending on livelihood security. Hence, this study aimed to determine the magnitude of NEBF and identify its associated factors by considering two areas with varied degrees of livelihood security. Methods This study represented a comparative cross-sectional survey of 1,060 under 6 months (u6m) infant-mother pairs. Both descriptive and analytic statistics were evaluated using STATA version 17 packages. A binary logistic regression was used to identify associated factors of NEBF. The odds ratio (OR) with a 95% confidence interval (CI) was used to measure the significance of the association at a p-value of <0.05. Results The pooled magnitude of 51% of NEBF mothers (95% CI: 48.0, 54.0) was 53.1% (95% CI: 49.2, 57.0) and 48.1% (95% CI: 43.4, 52.8) in livelihood-secure and livelihood-insecure areas, respectively. The lack of recollecting the infant's birth date by mothers (AOR = 2.4; 95% CI = 1.15-4.40) had the highest odds of NEBF while household heads with tertiary education (AOR = 0.14; 95% CI = 0.01-0.54) and the poorest households (AOR = 0.43; 95%CI = 0.20-0.82) had the lowest odds of NEBF in livelihood-secure areas but not in livelihood-insecure areas. Moreover, mothers with male infants (AOR = 1.9; 95% CI = 1.18-2.92) had high odds of NEBF in livelihood-insecure areas but not in livelihood-secure areas. Infants of 2 to less than 4-month-old (AOR = 8.5; 95% CI = 3.47-18.63) and 4 to less than 6-month-old (AOR = 22.2; 95% CI = 8.02-51.97) in livelihood-secure areas and infants of 2 to less than 4-month-old (AOR = 4.3; 95% CI = 1.29-11.67) and 4 to less than 6-month-old (AOR = 8.3; 95% CI = 2.44-22.39) in livelihood-insecure areas had high odds of NEBF. Conclusion Over half of the mothers were practicing NEBF, which represents a failure to meet national and international targets. Area vulnerability to livelihood security modifies factors of NEBF. Male infants in insecure areas, infants of unknown age in secure areas, and infants aged 2 months or older, regardless of setting, were more vulnerable to NEBF. However, households with the lowest wealth and higher household head educational status in livelihood-secure areas were less vulnerable to NEBF. Hence, livelihood-based interventions targeting mothers of 2 to less than 6-month-old infants, with emphasis on these factors, may help address and reduce NEBF.
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Affiliation(s)
- Ayenew Negesse
- Academic center of Excellence in Human Nutrition, School of Nutrition, Food Science and Technology (SNFST), Hawassa University, Hawassa, Ethiopia
- Department of Human Nutrition, College of Medicine and Health Science, Debre Markos University, Debre Markos, Ethiopia
| | - Tsinuel Girma
- Department of Paediatrics and Child Health, Jimma University, Jimma, Ethiopia
- University of British Colombia (UBC), Vancouver, BC, Canada
| | - Beruk Berhanu Desalegn
- Academic center of Excellence in Human Nutrition, School of Nutrition, Food Science and Technology (SNFST), Hawassa University, Hawassa, Ethiopia
| | - Marko Kerac
- London School of Hygiene and Tropical Medicine (LSHTM), London, United Kingdom
| | - Melkamu Berhane
- Department of Paediatrics and Child Health, Jimma University, Jimma, Ethiopia
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Teyton A, Ndovu A, Baer RJ, Bandoli G, Benmarhnia T. Disparities in the impact of heat wave definitions on emergency department visits during the first year of life among preterm and full-term infants in California. ENVIRONMENTAL RESEARCH 2024; 248:118299. [PMID: 38272297 DOI: 10.1016/j.envres.2024.118299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 01/04/2024] [Accepted: 01/22/2024] [Indexed: 01/27/2024]
Abstract
INTRODUCTION Heat waves will be aggravated due to climate change, making this a critical public health threat. However, heat wave definitions to activate alert systems can be ambiguous, highlighting the need to assess a range of definitions to identify those that contribute to the most adverse health outcomes. Additionally, children are highly susceptible to the impacts of heat waves, especially infants, despite the lack of focus on this subpopulation. We aimed to assess the relationship between 30 heat wave definitions and the first all-cause emergency department (ED) visits for California infants. We also examined modification of this relationship by preterm birth status and demographic characteristics to identify possible health disparities. METHODS Live-born, singleton deliveries from the Study of Outcomes in Mothers and Infants born in 2014-2018 were included. Thirty heat wave definitions were assessed based on temperature metrics (minimum/maximum temperatures), thresholds (90th; 92.5th; 95th; 97.5th; 99th percentiles), and duration (1-; 2-; 3-days). A time-stratified case-crossover design assessed heat wave impacts on ED visits using infants with a warm season ED visit (May-October) within the first year of life (n = 228,250). Effect modification by preterm birth status, age, sex, race/ethnicity, education, and delivery payment type was also investigated. RESULTS Infants demonstrated increased risk of an ED visit with exposure to all heat definitions. The 3-day minimum temperature 99th percentile definition had the highest adjusted odds ratio (AOR: 1.14; 95% CI: 1.05-1.23) for the total population. Term infants were more affected by some heat waves than preterm infants. Effect modification was additionally identified, such as by maternal education. DISCUSSION This study provides insight on the heat wave definitions that lead to adverse health outcomes and the identification of the most susceptible infants to these impacts, which has implications on heat-related interventions.
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Affiliation(s)
- Anaïs Teyton
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, 9500 Gilman Drive, La Jolla, CA, 92093, USA; School of Public Health, San Diego State University, 5500 Campanile Dr, San Diego, CA, 92182, USA; Scripps Institution of Oceanography, University of California, San Diego, 8885, Biological Grade, La Jolla, CA, 92037, USA.
| | - Allan Ndovu
- University of California San Francisco School of Medicine, 533 Parnassus Ave, San Francisco, CA, 94143, USA
| | - Rebecca J Baer
- California Preterm Birth Initiative, University of California, San Francisco, 490 Illinois Street, Flr. 9 Box 2930, San Francisco, CA, 94143, USA; Department of Pediatrics, University of California, San Diego, 9500 Gilman Drive, La Jolla, CA, 92093, USA
| | - Gretchen Bandoli
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, 9500 Gilman Drive, La Jolla, CA, 92093, USA; Department of Pediatrics, University of California, San Diego, 9500 Gilman Drive, La Jolla, CA, 92093, USA
| | - Tarik Benmarhnia
- Scripps Institution of Oceanography, University of California, San Diego, 8885, Biological Grade, La Jolla, CA, 92037, USA
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Babakazo P, Piripiri LM, Mukiese JM, Lobota N, Mafuta É. Breastfeeding practices and social norms in Kinshasa, Democratic Republic of the Congo: A qualitative study. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0000957. [PMID: 38626214 PMCID: PMC11020689 DOI: 10.1371/journal.pgph.0000957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Accepted: 03/27/2024] [Indexed: 04/18/2024]
Abstract
INTRODUCTION Breastfeeding has many benefits for both mothers and children. The World Health Organization recommends exclusive breastfeeding for the first six months of life. However, in the Democratic Republic of the Congo, slightly under half of children under six months are exclusively breastfed. This study aimed to describe breastfeeding practices and to explore perceived social norms regarding breastfeeding among mothers in Kinshasa. MATERIALS AND METHODS A qualitative descriptive study was conducted in Kinshasa from June to July 2013. This study purposively sampled 54 mothers of infants aged 6 to 12 months, who participated in six focus group discussions. Based on the Theory of Planned Behaviour, the discussion guide explored infant feeding in the first six months, knowledge of breastfeeding, perception of the feasibility of exclusive breastfeeding, and perception of the social norms with regard to exclusive breastfeeding. The content analysis approach was used to analyse data. RESULTS Mothers had good breastfeeding knowledge; however, few of them had practised exclusive breastfeeding as recommended during the first six months. Exclusive breastfeeding was considered unfeasible in their context. Barriers to exclusive breastfeeding were reported as baby's cries, social pressure, warm climate, and poor maternal diet. Social norms were supportive of breastfeeding but unfavourable to exclusive breastfeeding. CONCLUSION In Kinshasa, mothers have a good knowledge of breastfeeding. However, few practise exclusive breastfeeding. Social pressure plays an important role in the cessation of exclusive breastfeeding before six months. In order to improve the practice of exclusive breastfeeding in this context, social and behaviour change programmes should target the entire population rather than mothers only.
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Affiliation(s)
- Pélagie Babakazo
- Kinshasa School of Public Health, University of Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Lina M. Piripiri
- Kinshasa School of Public Health, University of Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Jean-Marie Mukiese
- Kinshasa School of Public Health, University of Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Nelly Lobota
- Hôpital Général de Référence de Makala, Kinshasa, Democratic Republic of the Congo
| | - Éric Mafuta
- Kinshasa School of Public Health, University of Kinshasa, Kinshasa, Democratic Republic of the Congo
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Lusambili A, Kovats S, Nakstad B, Filippi V, Khaemba P, Roos N, Part C, Luchters S, Chersich M, Hess J, Kadio K, Scorgie F. Too hot to thrive: a qualitative inquiry of community perspectives on the effect of high ambient temperature on postpartum women and neonates in Kilifi, Kenya. BMC Pediatr 2024; 24:36. [PMID: 38216969 PMCID: PMC10787431 DOI: 10.1186/s12887-023-04517-w] [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: 06/20/2023] [Accepted: 12/29/2023] [Indexed: 01/14/2024] Open
Abstract
OBJECTIVE To understand community perspectives on the effects of high ambient temperature on the health and wellbeing of neonates, and impacts on post-partum women and infant care in Kilifi. DESIGN Qualitative study using key informant interviews, in-depth interviews and focus group discussions with pregnant and postpartum women (n = 22), mothers-in-law (n = 19), male spouses (n = 20), community health volunteers (CHVs) (n = 22) and stakeholders from health and government ministries (n = 16). SETTINGS We conducted our research in Kilifi County in Kenya's Coast Province. The area is largely rural and during summer, air temperatures can reach 37˚C and rarely go below 23˚C. DATA ANALYSIS Data were analyzed in NVivo 12, using both inductive and deductive approaches. RESULTS High ambient temperature is perceived by community members to have direct and indirect health pathways in pregnancy and postpartum periods, including on the neonates. The direct impacts include injuries on the neonate's skin and in the mouth, leading to discomfort and affecting breastfeeding and sleeping. Participants described babies as "having no peace". Heat effects were perceived to be amplified by indoor air pollution and heat from indoor cooking fires. Community members believed that exclusive breastfeeding was not practical in conditions of extreme heat because it lowered breast milk production, which was, in turn, linked to a low scarcity of food and time spend by mothers away from their neonates performing household chores. Kangaroo Mother Care (KMC) was also negatively affected. Participants reported that postpartum women took longer to heal in the heat, were exhausted most of the time and tended not to attend postnatal care. CONCLUSIONS High ambient temperatures affect postpartum women and their neonates through direct and indirect pathways. Discomfort makes it difficult for the mother to care for the baby. Multi-sectoral policies and programs are required to mitigate the negative impacts of high ambient temperatures on maternal and neonatal health in rural Kilifi and similar settings.
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Affiliation(s)
- Adelaide Lusambili
- Environmental Health and Governance Center, Leadership and Governance Hub, School of Business, Africa International University, Nairobi, Kenya.
| | - Sari Kovats
- Centre on Climate Change and Planetary Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Britt Nakstad
- Division of Pediatric and Adolescent Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Veronique Filippi
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Peter Khaemba
- Institute for Human Development, Aga Khan University, Nairobi, Kenya
| | - Nathalie Roos
- Department of Medicine, Clinical Epidemiology Division, Karolinska Institutet, Stockholm, Sweden
| | - Cherie Part
- Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK
| | - Stanley Luchters
- Department of International Public Health, Liverpool School of Tropical Medicine (LSTM), Liverpool, UK
| | - Matthew Chersich
- Wits Reproductive Health and HIV Institute (Wits RHI), Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Jeremy Hess
- Emergency Medicine, Env & Occ Health Sciences, and Global Health, University of Washington, Washington, USA
| | - Kadidiatou Kadio
- Institute de Recherche en Siences de la Santé, Bobo-Dioulasso, Burkina Faso
| | - Fiona Scorgie
- Wits Reproductive Health and HIV Institute (Wits RHI), Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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