Bland, R; Rollins, N; Solarsh, G; Van den Broeck, J; Coovadia, H
Background: Both the pattern and duration of breast feeding are important determinants of health outcomes. In vertical HIV transmission research, reliable documentation of early breast feeding practices is important in order to correctly attribute postnatal transmission to feeding pattern. Aims: To validate methods of collecting data on the duration of exclusive breast feeding (EBF) in an area of South Africa with a high HIV prevalence rate. Methods: A total of 130 mothers were interviewed weekly, postnatally. At every interview a 48 hour and a seven day recall breast feeding history were taken. A subset of 70 mothers also received two intermediate visits per week during which additional 48 hour, non-overlapping, recall interviews were conducted. Ninety three infants were revisited at 6–9 months of age when mothers' recall of EBF duration from birth was documented. The different methods of recalling EBF status were compared against an a priori "best comparison" in each case. Results: Reported breast feeding practices over the previous 48 hours did not reflect EBF practices since birth (specificity 65–89%; positive predictive value 31–48%). Six month EBF duration recall was equally poor (sensitivity at 2 weeks 79%; specificity 40%). Seven day recall accurately reflected EBF practices compared with thrice weekly recall over the same time period (sensitivity 96%, specificity 94%). Conclusions: 48 hour EBF status does not accurately reflect feeding practices since birth. Long term recall data on EBF are even more inaccurate. We recommend that data on duration of EBF be collected prospectively at intervals of no longer than one week. PMID:12937095
Abbass-Dick, Jennifer; Dennis, Cindy-Lee
Targeting mothers and fathers in breast-feeding promotion programs is recommended as research has found that father's support positively impacts breast-feeding duration and exclusivity. Breast-feeding coparenting refers to the manner in which parents work together to achieve their breast-feeding goals. The Breast-feeding Coparenting Framework was developed on the basis of diverse coparenting models and research related to father's involvement with breast-feeding. This framework consists of 5 components: joint breast-feeding goal setting, shared breast-feeding responsibility, proactive breast-feeding support, father's/partner's parental-child interactions, and productive communication and problem solving. This framework may be of value to policy makers and program providers working to improve breast-feeding outcomes.
Laugen, Chris M; Islam, Nazrul; Janssen, Patricia A
The World Health Organization recommendation for exclusive breast feeding for 6 months has been endorsed by Health Canada, the Canadian Pediatric Society, Dietitians of Canada, and the Breastfeeding Committee for Canada as of 2012. This study examines whether social support is associated with exclusive breast feeding up to 6 months among Canadian mothers. We utilised data from the Canadian Community Health Survey and limited our sample to mothers who gave birth in the 5 years prior to the 2009-2010 survey (n = 2133). Multivariable logistic regression was used to examine the relationship between exclusive breast feeding and four dimensions of social support: (i) tangible, (ii) affectionate, (iii) positive social interaction, and (iv) emotional and informational, based on the Medical Outcomes Study Social Support Scale. Absolute and relative differences in the probability of breast feeding exclusively and their 95% confidence intervals were calculated. In adjusted models, differences in the probability of exclusive breast feeding for 6 months were not different among women with high vs. low social support. The association between social support and breastfeeding exclusively was modified by education level, with significantly higher probability of breast feeding exclusively among women with lower education and high vs. low levels of tangible and affectionate support. Among women with education below a high school level, high tangible and affectionate support significantly increased probability of exclusive breast feeding for 6 months in this study. Efforts to encourage exclusive breast feeding need to address social support for mothers, especially those with lower education. © 2016 John Wiley & Sons Ltd.
Kristiansen, Anne Lene; Lande, Britt; Øverby, Nina Cecilie; Andersen, Lene Frost
To identify factors associated with exclusive breast-feeding and breast-feeding during the first year of life among Norwegian infants. Data on breast-feeding practices were collected by a semi-quantitative FFQ. In 2006-2007 about 3000 infants were invited to participate in a population-based prospective cohort study in Norway. A total of 1490 mothers/infants participated at both 6 and 12 months of age. Exclusive breast-feeding at 4 months was associated with parental education, parity and geographical region, while exclusive breast-feeding at 5·5 months was associated only with maternal age. At both ages, a negative association with exclusive breast-feeding was observed for maternal smoking. Breast-feeding at 6 months was associated with parental education, maternal age and marital status. Breast-feeding at 12 months was associated with maternal education, maternal age and number of children. At both ages, negative associations with breast-feeding were observed for maternal smoking and descending birth weight. At 12 months, a negative association was also observed for having day care by other than the parents. Even though Norway has an extensive and positive breast-feeding tradition and a maternal leave system that supports the possibility to breast-feed, factors like maternal education, maternal age and maternal smoking are strongly associated with duration of exclusive breast-feeding and breast-feeding. Research to better understand the reasons for inequalities in breast-feeding is needed to facilitate the development of more effective breast-feeding promotion strategies. This again may improve compliance with recommendations and reduce inequalities in infant feeding practices.
Giannì, M L; Vegni, C; Ferraris, G; Mosca, F
Exclusive breast-feeding is recommended during the first 6 months of life. Use of simple indicators to predict early stopping of exclusive breast-feeding may be desirable in clinical practice. A breast-feeding assessment evaluated at discharge and including maternal age, previous breast-feeding experience, latching difficulty, and breast-feeding interval could be useful.
Bærug, Anne; Laake, Petter; Løland, Beate Fossum; Tylleskär, Thorkild; Tufte, Elisabeth; Fretheim, Atle
In high-income countries, lower socioeconomic position is associated with lower rates of breast feeding, but it is unclear what factors explain this inequality. Our objective was to examine the association between socioeconomic position and exclusive breast feeding, and to explore whether socioeconomic inequality in exclusive breast feeding could be explained by other sociodemographic characteristics, for example, maternal age and parity, smoking habits, birth characteristics, quality of counselling and breastfeeding difficulties. We used data from a questionnaire sent to mothers when their infants were five completed months as part of a trial of a breastfeeding intervention in Norway. We used maternal education as an indicator of socioeconomic position. Analyses of 1598 mother-infant pairs were conducted using logistic regression to assess explanatory factors of educational inequalities in breast feeding. Socioeconomic inequalities in exclusive breast feeding were present from the beginning and persisted for five completed months, when 22% of the most educated mothers exclusively breast fed compared with 7% of the least educated mothers: OR 3.39 (95% CI 1.74 to 6.61). After adjustment for all potentially explanatory factors, the OR was reduced to 1.49 (95% CI 0.70 to 3.14). This decrease in educational inequality seemed to be mainly driven by sociodemographic factors, smoking habits and breastfeeding difficulties, in particular perceived milk insufficiency. Socioeconomic inequalities in exclusive breast feeding at 5 months were largely explained by sociodemographic factors, but also by modifiable factors, such as smoking habits and breastfeeding difficulties, which can be amenable to public health interventions. NCT01025362. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.
Lunney, Kevin M; Iliff, Peter; Mutasa, Kuda; Ntozini, Robert; Magder, Laurence S; Moulton, Lawrence H; Humphrey, Jean H
. Exclusive breast-feeding is protective against postnatal transmission of human immunodeficiency virus (HIV), compared with mixed breast-feeding. Accordingly, exclusive breast-feeding for 6 months is the World Health Organization's recommendation to HIV-infected mothers for whom exclusive replacement feeding is not acceptable, feasible, affordable, safe, or sustainable. The mechanism of exclusive breast-feeding protection is unknown but is hypothesized to be mediated through reduced mastitis. We compared breast milk and plasma specimens of exclusive breast-feeding and mixed breast-feeding HIV- positive mothers archived from the ZVITAMBO trial in which mixed breast-feeding was associated with a 2-fold increased risk of postnatal transmission at 18 months. Plasma HIV load, breast milk HIV load and sodium/potassium ratio were measured as a proxy for subclinical mastitis. Mixed breast-feeding was not associated with mastitis or breast milk HIV load. Mastitis was associated with breast milk HIV load, and this effect increased with increasing maternal plasma HIV load; mastitis was associated with postnatal transmission only when maternal plasma HIV load was high (>3.7 log(10) copies/mL). Initiation of breast-feeding within an hour of delivery was associated with exclusive breast-feeding (adjusted odds ratio, 1.62; 95% confidence interval, 1.02-2.58). Exclusive breast-feeding is associated with reduced postnatal transmission of HIV from mother to child, but this protection is not mediated by reduced mastitis or breast milk HIV load. The deleterious effect of mastitis increases as the mother's plasma HIV load increases.
Chan, Man Yi; Ip, Wan Yim; Choi, Kai Chow
breast feeding has a number of well-documented benefits. Numerous studies have been conducted to investigate an effective approach to increase the breast feeding rate, duration and exclusive breast feeding rate, in which maternal breast feeding self-efficacy was determined as one of the major contributors. Although numerous breast feeding educational programmes have been developed to enhance maternal breastfeeding self-efficacy, results on the effectiveness of these programmes remain inconclusive. this study aims to investigate the effectiveness of a self-efficacy-based breast feeding educational programme (SEBEP) in enhancing breast feeding self-efficacy, breast feeding duration and exclusive breast feeding rates among mothers in Hong Kong. eligible pregnant women were randomized to attend a 2.5-hour breast feeding workshop at 28-38 weeks of gestation and receive 30-60minutes of telephone counselling at two weeks post partum, whereas both intervention and control groups received usual care. At two weeks postpartum, the Breast feeding Self-Efficacy Scale-Short Form (BSES-SF) and a self-developed post partum questionnaire were completed via telephone interviews. The breast feeding duration, pattern of breast feeding and exclusive breast feeding rates were recorded at two weeks, four weeks, eight weeks and six months post partum. results of analyses based on an intention-to-treat (ITT) assumption showed a significant difference (p<0.01) in the change in BSES-SF mean scores between the mothers who received SEBEP and those who did not receive SEBEP at two weeks post partum. The exclusive breast feeding rate was 11.4% for the intervention group and 5.6% for the control group at six months post partum. the findings of this study highlight the feasibility of a major trial to implement breast feeding education targeted at increasing breast feeding self-efficacy and exclusive breast feeding rates in Hong Kong. Copyright © 2016 Elsevier Ltd. All rights reserved.
Singh, D; Devi, N; Raman, Ts Raghu
Human milk is the ideal source of nutrition for full term neonates, but there is controversy regarding its use as a nutrition source for preterm and low birth weight infants. However current data supports the use of human milk for low birth weight infants. This study was undertaken to evaluate the growth of both preterm and term small for gestational age infants nursed on exclusive breast milk from birth to four months of age. This was a prospective, longitudinal study carried out in a recognized baby-friendly hospital where exclusive breast-feeding is practiced in all neonates. All consecutive low birth weight neonates irrespective of gestational age, born during the study period of two years were included in the study. Assessment of growth parameters included recording of weight (daily when in the hospital and later weekly), length (weekly) and head circumference (weekly) till the age of four months. Low birth weight infants, both the preterm and the term small for gestational age, on being exclusively breastfed by their own mothers, gained weight and had an increase in their head circumference and length to the levels almost comparable to the standard fetal- infant growth norms. Exclusive breast-feeding results in adequate growth in low birth weight babies including preterms.
Aidam, Bridget A; Pérez-Escamilla, Rafael; Lartey, Anna
Exclusive breast-feeding (EBF) rates remain low despite numerous health benefits associated with this behavior. We conducted a randomized trial on the effect of lactation counseling on EBF, which controlled for the Hawthorne effect while also varying the timing of the intervention. Pregnant women attending prenatal clinics in Tema were randomly assigned to 1 of 2 intervention groups (IG) or to a control group (C), as follows: 1) EBF support given pre-, peri-, and postnatally (IG1; n = 43); 2) EBF support given only peri- and postnatally (IG2; n = 44); or 3) nonbreast-feeding health educational support (C; n = 49) that had an equal amount of contact with lactation counselors. Two educational sessions were provided prenatally, and 9 home follow-up visits were provided in the 6-mo postpartum period. Infant feeding data were collected monthly at the participant's home. The 3 groups did not differ in sociodemographic characteristics. At 6 mo postpartum, 90.0% in IG1 and 74.4% in IG2 had exclusively breast-fed during the previous month. By contrast, only 47.7% in C were doing so (P = 0.008). Similarly, the percentage of EBF during the 6 mo was significantly higher (P = 0.02) among IG1 and IG2 (39.5%) than among C (19.6%). The 100% increase in EBF rates can be attributed to the lactation counseling provided. Additional prenatal EBF support may not be needed within a context of strong routine prenatal EBF education.
Yourkavitch, Jennifer; Zadrozny, Sabrina; Flax, Valerie L.
The practice of feeding infants expressed breast milk is increasing in the United States, but the impacts on infant and maternal health are still understudied. This study examines the monthly incidence of regurgitation (gastro-esophageal reflux) in exclusively breast milk fed infants from ages two to six months. Among infants whose mothers participated in the Infant Feeding Practices II Study (IFPS II; 2005–2007), data on reflux and feeding mode were collected by monthly questionnaires. A longitudinal, repeated measures analysis was used, with feeding mode lagged by one month in order to compare reflux incidence among infants fed directly at the breast to infants receiving pumped breast milk. Mothers in both feeding groups had similar characteristics, although a greater proportion feeding at least some pumped milk were primiparous. The number of exclusively breastfed infants decreased steadily between months 2 and 6, although the proportion fed at the breast remained similar over time. An association between feeding mode and reflux incidence was not found; however, the analyses were limited by a small number of reported reflux cases. More studies are needed to further explain the relationship between different feeding modes and infant reflux. PMID:27754430
Yourkavitch, Jennifer; Zadrozny, Sabrina; Flax, Valerie L
The practice of feeding infants expressed breast milk is increasing in the United States, but the impacts on infant and maternal health are still understudied. This study examines the monthly incidence of regurgitation (gastro-esophageal reflux) in exclusively breast milk fed infants from ages two to six months. Among infants whose mothers participated in the Infant Feeding Practices II Study (IFPS II; 2005-2007), data on reflux and feeding mode were collected by monthly questionnaires. A longitudinal, repeated measures analysis was used, with feeding mode lagged by one month in order to compare reflux incidence among infants fed directly at the breast to infants receiving pumped breast milk. Mothers in both feeding groups had similar characteristics, although a greater proportion feeding at least some pumped milk were primiparous. The number of exclusively breastfed infants decreased steadily between months 2 and 6, although the proportion fed at the breast remained similar over time. An association between feeding mode and reflux incidence was not found; however, the analyses were limited by a small number of reported reflux cases. More studies are needed to further explain the relationship between different feeding modes and infant reflux.
Gijsbers, Barbara; Mesters, Ilse; Knottnerus, J André; van Schayck, Constant P
This study was part of a randomized controlled trial in which verbal and written advice about exclusive breast-feeding for 6 months was provided to Dutch women expecting a child with a high risk of developing asthmatic traits. Eighty-nine women completed a theory-based self-report questionnaire between the third and sixth months of pregnancy, which served as the baseline measurement. The aim of this study was to examine the factors that influence the duration of exclusive breast-feeding. Cox multiple regression analysis showed a positive significant association between the duration of exclusive breast-feeding and the mother's breast-feeding knowledge (P < 0.01), her intended hours of work per week after maternity leave (P < 0.01) and her age (P
The aim of the present study was to identify the prevalence of exclusive breast-feeding after 2,4, and 6 months in Rajavithi Hospital. The present study evaluated the factors associated with discontinuing breast-feeding before the first two months of life in order to target early nursing interventions to encourage and support continued breast-feeding and increase the exclusive breast-feeding rate. From September 2010 to May 2011, mothers were interviewed prior to hospital discharge from the maternity ward and follow-up phone calls were made after 2,4 and 6 months postpartum. The prevalence of exclusive breast-feeding after 2, 4 and 6 months was 57.9% (252 out of 435), 32.0% (139 out of 435) and 4.8% (21 out of435) respectively. At 2 months postpartum, multivariate analysis was carried out to identify whether maternal obesity and breast-feeding intervals of more than 3 hours had a statistically significant association with cessation of breast-feeding. The most common reason for cessation of exclusive breast-feeding by mothers was their return to work. The prevalence of exclusive breast-feeding at 2, 4, and 6 months was 57.9%, 32.0% and 4.8%, respectively. Maternal obesity, and maternal breast-feeding for intervals of more than 3 hours prior to hospital discharge were risk factors of early breast-feeding cessation at 2 months postpartum. This is an area on which we would target nursing interventions to prevent early unintended weaning.
Küçükoğlu, Sibel; Çelebioğlu, Ayda
Objective: The ideal nourishment for newborns with low birth-weight is breast milk. The purpose of the study was to determine the effect of natural-feeding education given to mothers of low-birth-weight infants, on the mothers’ breast-feeding self-efficacy level, breast-feeding success, and the growth of the infants. Methods: The study was conducted in a quasi-experimental way. The study group consisted of a total of 85 low-birth-weight infants and their mothers who had been treated in the neonatal clinics of two hospitals. The mothers included in the test group were given breast-feeding education for half an hour per day, during the first 5 days of their hospitalization. Home visits were carried out at the homes of the participants from both the test and control groups, until the infants reached 6 months of age. For collecting data, the following forms were used: Personal Information Form, Breast-feeding Self-Efficacy Form, LATCH Breast-feeding Assessment Tool, and Anthropometric Measurements Form. For analyzing the collected data, percentage, arithmetic mean, standard deviation, and chi-square we used, and, in independent groups, t-tests were employed. Findings : It was determined that natural-feeding education given to the mothers increases their breast-feeding self-efficacy levels and success in breast-feeding (P<0.05). It was found that in the test group, the rate of feeding the infants exclusively with breast milk is higher in comparison with the control group (P<0.001). Conclusion: Results of the study indicate that natural-feeding education increases breast-feeding self-efficacy levels, breast-feeding success, and the breast-feeding duration. PMID:25793045
The aim of this review was to identify if exclusive breast-feeding reduced the risk of coeliac disease (CD) in children. Medline, Embase and CINAHL databases were searched for cohort studies and case control studies that compared exclusive breast-feeding rates with formula or mixed (breast and formula) of the same duration. Three case control studies met the review criteria and were included in the review. The results from these studies show that there is a reduced risk in the onset of CD in those children who were exclusively breast-fed compared to those who were not. However, the design of these studies did not allow a causal relationship to be established. The evidence from these studies suggests a delay in the onset of CD in breast-fed children, however it cannot be ruled out that breast-feeding continues to have a protective factor in adolescence and adulthood. The exact role of breast-feeding in CD prevention needs to be clarified: is it a protective factor against CD, or does it delay the appearance of clinical symptoms? Parents should continue to be encouraged and supported with breast-feeding, as it is the best form of infant nutrition and protective against short and long-term health outcomes.
Ayton, Jennifer; van der Mei, Ingrid; Wills, Karen; Hansen, Emily; Nelson, Mark
To estimate the prevalence of cessation of exclusive breast feeding at each month up to 6 months and document key factors and cumulative risks associated with exclusive breastfeeding cessation for children aged from 0 to 6 months. Secondary analysis using a national representative sample of 22 202 mother and infant pairs derived from the 2010 Australian Institute of Health and Welfare cross-sectional survey, the Australian Infant Feeding Survey. Among breastfed infants, 49% had ceased exclusive breast feeding before they had reached 2 months of age. In the final Cox proportional hazards model, cessation of exclusive breast feeding was most strongly associated with partners preferring bottle feeding (HR 1.86, 95% CI 1.69 to 20.6) or having no preference (HR 1.37, 95% CI 1.33 to 1.42), regular dummy use (HR 1.35, 95% CI 1.31 to 1.39) and maternal obesity (HR 1.29, 95% CI 1.24 to 1.35). Living within the most disadvantaged areas of Australia (quintile 1) was not strongly associated with cessation (HR 1.08, 95% CI 1.02 to 1.14) compared with least disadvantaged areas. Having three risk factors significantly increased the risk of cessation by 31% (HR 1.31, 95% CI 1.07 to 1.6). The prevalence of early cessation of exclusive breast feeding is alarmingly high with 50% of infants no longer exclusively breast fed by age 2 months. Given that not one factor is associated with cessation of exclusive breast feeding, the greatest public health impact is likely to be achieved when multiple risk factors are modified or prevented. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
Coutinho, Sonia B; Lira, Pedro Ic; Lima, Marilia C; Frias, Paulo G; Eickmann, Sophie H; Ashworth, Ann
Breast-feeding counselling has been identified as the intervention with the greatest potential for reducing child deaths, but there is little experience in delivering breast-feeding counselling at scale within routine health systems. The study aim was to compare rates of exclusive breast-feeding associated with a breast-feeding counselling intervention in which community health agents (CHA) received 20 h of training directed at counselling and practical skills with rates pre-intervention when CHA received 4 h of didactic teaching. Cross-sectional surveys of breast-feeding practices were conducted pre- and post-intervention in random samples of 1266 and 1245 infants aged 0-5.9 months, respectively. Recife, Brazil, with a population of 2 million. CHA (n 1449) of Brazil's Family Health Programme were trained to provide breast-feeding counselling at home visits. Rates of exclusive breast-feeding improved when CHA were trained to provide breast-feeding counselling and were significantly higher by 10-13 percentage points at age 3-5.9 months when compared with pre-intervention rates (P < 0.05). Post-intervention point prevalence of exclusive breast-feeding for infants aged <4 months was 63% and for those aged <6 months was 50%. Multifunctional CHA were able to deliver breast-feeding counselling at scale within a routine health service and this was associated with a significant increase in rates of exclusive breast-feeding. The study reinforces the need to focus training on counselling and practical skills; a key component was an interactive style that utilized the knowledge and experience of CHA. The findings are relevant to the call by international organizations to scale up breast-feeding counselling.
Kramer, Michael S; Matush, Lidia; Vanilovich, Irina; Platt, Robert; Bogdanovich, Natalia; Sevkovskaya, Zinaida; Dzikovich, Irina; Shishko, Gyorgy; Mazer, Bruce
To assess whether exclusive and prolonged breast feeding reduces the risk of childhood asthma and allergy by age 6.5 years. Cluster randomised trial. 31 Belarussian maternity hospitals and their affiliated polyclinics. A total of 17,046 mother-infant pairs were enrolled, of whom 13,889 (81.5%) were followed up at age 6.5 years. Breastfeeding promotion intervention modelled on the WHO/UNICEF baby friendly hospital initiative. International study of asthma and allergies in childhood (ISAAC) questionnaire and skin prick tests of five inhalant antigens. The experimental intervention led to a large increase in exclusive breast feeding at 3 months (44.3% v 6.4%; P<0.001) and a significantly higher prevalence of any breast feeding at all ages up to and including 12 months. The experimental group had no reduction in risks of allergic symptoms and diagnoses or positive skin prick tests. In fact, after exclusion of six sites (three experimental and three control) with suspiciously high rates of positive skin prick tests, risks were significantly increased in the experimental group for four of the five antigens. These results do not support a protective effect of prolonged and exclusive breast feeding on asthma or allergy. Current Controlled Trials ISRCTN37687716 [controlled-trials.com].
Kim, Myo Jing; Kim, Yu-Mi; Yoo, Jae-Ho
The aim of this study was to identify the status of exclusive breast-feeding (EBF) in Korea and analyze the factors affecting exclusive breast-feeding at 6 months of age. This study was based on data obtained from the Korea National Health and Nutrition Examination Survey (KNHANES) IV, conducted from January 2007 to December 2008. A total of 404 mother-infant pairs were recruited. Exclusive breast-feeding was defined according to the criteria established by the World Health Organization. The rate of EBF was 60.9% for 1 month, 55.0% for 3 months, 35.4% for 6 months, 3.7% for 9 months and 1.2% for 12 months after birth. According to a stepwise logistic regression analysis, factors that were positively associated with EBF at 6 months were younger maternal age (odds ratio [OR] = 0.85, 95% confidence interval [CI]: 0.79-0.92), higher maternal education level (OR = 2.29, 95%CI: 1.17-4.46) and living in a capital city (OR = 2.64, 95%CI: 1.46-4.75). The rate of EBF in Korea is still suboptimal. To promote EBF, persistent and systematic education and campaigns for breast-feeding should be provided, particularly in vulnerable regions. © 2012 The Authors. Pediatrics International © 2012 Japan Pediatric Society.
Muchacha, Munyaradzi; Mtetwa, Edmos
Exclusive breast feeding (EBF) uptake in Zimbabwe is very low. Given that EBF is a physiological process which transpires in a specific socio-economic milieu, this study investigates the socio-economic factors militating against its uptake. The study used a mixed research methodology. The concurrent nested model of mixed methods was utilized using one data collection phase, during which both quantitative and qualitative data were collected simultaneously. The research noted that factors such as low education, low income, gender inequalities, social influence, and traditional practices were hindering the uptake of exclusive breast feeding. The study envisages that it is pertinent for infant feeding programs to address socio-economic barriers to EBF in order to influence a positive uptake. The potential interventions include increasing men's involvement, raising awareness on EBF, and strengthening the Village Health Worker Program.
Carrascoza, Karina Camilo; Possobon, Rosana de Fátima; Ambrosano, Gláucia Maria Bovi; Costa Júnior, Aderson Luiz; Moraes, Antônio Bento Alves de
To identify variables potentially related with the exclusive breastfeeding abandonment in children assisted by interdisciplinary program on breast feeding promotion. Data were collected by a longitudinal study with 111 mothers who breastfeed their children until six months of age. Univariate analyses were used to assess factors associated with the exclusive breastfeeding abandonment, and also multiple regression analyses. The mothers were divided in two groups: 57 mothers breastfeed, exclusively, their children until six months of age and 54 mothers introduced other kinds of food before this age. The following variables were found to be factors associated with the exclusive breastfeeding abandonment: pacifier use (OR 4,65; IC95% 1,66-12,99), social and economic high level (OR 11,46; IC95% 3,09-42,37) and mother's work (OR 2,44; IC95% 0,91-5,62). Pacifier use, social and economic high level and mother's work are associated with the exclusive breastfeeding abandonment.
Sasaki, Yuri; Ali, Moazzam; Kakimoto, Kazuhiro; Saroeun, Ou; Kanal, Koum; Kuroiwa, Chushi
Exclusive breast-feeding (EBF) is recommended in the first 6 months of an infant's life. This study aims to investigate the present status of infant feeding practices and identify factors that affect EBF practices during the first 6 months following infant birth in Phnom Penh, Cambodia. A cross-sectional survey with a semistructured questionnaire was given to 312 mothers with children aged 6 to 24 months who visited the immunization clinic in the National Maternal and Child Health Centre in Phnom Penh, Cambodia, from December 2005 to February 2006. Eighty-three percent of mothers fed breast milk exclusively in the first month, whereas only 51.3% continued EBF in the first 6 months. Within 30 minutes after delivery, 39% of mothers began breast-feeding. Results from logistic regression analysis indicate that the lack of a maternal antenatal EBF plan (odds ratio [OR] = 10.01, 95% confidence interval [CI] = 3.68-27.24, p < .001), working mothers (OR = 4.71, 95% CI = 2.77-8.01, p < .001), and lack of paternal attendance at breast-feeding classes (OR = 1.93, 95% CI = 1.13-3.28, p < .05) have independently positive associations with cessation of EBF during the first 6 months of infant life. The findings have helped to identify some important factors affecting EBF practices in the study area in Cambodia. The findings revealed that it is important to educate pregnant mothers, probably through exposure to trained midwives and media, so they may recognize the significance of EBF and will develop intention and plan to feed their babies, keeping in mind the benefits it may yield. Paternal involvement in breast-feeding classes may increase their awareness and consequently complement EBF practices. Finally, development of conducive working environments and policies for working mothers should be carefully explored because it could have positive influence in better care and promotion of EBF. Copyright © 2010 Elsevier Inc. All rights reserved.
Henkle, Emily; Steinhoff, Mark C; Omer, Saad B; Roy, Eliza; Arifeen, Shams E; Raqib, Rubhana; Breiman, Robert F; Caulfield, Laura E; Moss, William J; Zaman, Khalequ
Exclusive breast-feeding reduces the risk of respiratory illness in infants younger than 6 months of age in developing countries by approximately half. We evaluated the effect of exclusive breast-feeding on respiratory illness with fever (RIF) in Bangladeshi infants in the context of a randomized maternal influenza immunization trial. Infants in a maternal vaccine trial in Dhaka, Bangladesh, were prospectively assessed at weekly intervals for 6 months after birth for breast-feeding practices and RIF. We estimated the risk of an RIF episode for infants who were exclusively breast-fed the prior week compared with infants not exclusively breast-fed the prior week using generalized estimating equations. We followed a total of 331 infants from birth to 24 weeks of age. The median weeks infants were exclusively breast-fed was 15 (interquartile range, 6-21). The adjusted independent odds of respiratory illness for exclusively breast-fed infants compared with nonexclusively breast-fed infants was 0.59 (95% confidence interval: 0.45-0.77) for an RIF episode. After adjusting for exclusive breast-feeding, we confirmed the previous report that maternal immunization with influenza vaccine had an independent protective effect against RIF (odds ratio, 0.72; 95% confidence interval: 0.55-0.93). No significant difference in the protective effect of exclusive breast-feeding was seen by maternal influenza immunization status. Exclusive breast-feeding during the first 6 months of life and maternal immunization with influenza vaccine independently and substantially reduced respiratory illness with fever in infants.
Abuidhail, Jamila; Al-Modallal, Hanan; Yousif, Rania; Almresi, Neamat
of this study is to investigate the prevalence, duration, practices and barriers of Exclusive breast feeding (EBF) among Jordanian mothers in three major governorates. longitudinal, prospective design was used in this study. convenience sample of 572 pairs of postpartum mothers-infants were recruited from postpartum wards at three governmental hospitals and three private hospitals in major Jordanian governorate. data were collected in two phases. In the first phase, trained research assistants conducted face to face structured interviews with participating mothers at the hospital. In the second phase, the research assistants conducted follow up phone interviews at the end of first, fourth and sixth months after birth. The findings of this study showed that the prevalence of EBF as recommended by WHO was 1%. The average duration of EBF was one month. The main barriers of EBF were: infants feel hungry after breast feeding, short period between pregnancies, and breast problems. postpartum mothers initiated EBF practice within the first hour after giving birth; however, this practice declined gradually as the infant grew up within the first six months after birth. antenatal education sessions in the Jordanian governmental hospitals about EBF are required to meet the WHO recommendations. Furthermore, midwives and nurses have to focus on effective breast feeding process to overcome the barriers of EBF during antenatal education and postnatal care. Copyright © 2013 Elsevier Ltd. All rights reserved.
Frith, Amy L; Ziaei, Shirin; Naved, Ruchira Tabassum; Khan, Ashraful Islam; Kabir, Iqbal; Ekström, Eva-Charlotte
To determine if exclusive breast-feeding counselling modifies the association of experience of any lifetime or specific forms of domestic violence (DV) on duration of exclusive breast-feeding (EBF). In the MINIMat trial pregnant women were randomized to receive either usual health messages (UHM) or usual health messages with breast-feeding counselling (BFC) in eight visits. During pregnancy (30 weeks), lifetime experience of any or specific forms of DV was measured. Infant feeding practice information was collected from 0 to 6 months at 15 d intervals. Matlab, Bangladesh. Pregnant and postpartum women (n 3186) and their infants. Among women in the UHM group, those who had experienced any lifetime DV exclusively breast-fed for a shorter duration than women who did not experience any lifetime DV (P=0·02). There was no difference, however, in duration of EBF among women in the BFC group based on their experience of any lifetime DV exposure (P=0·48). Using Cox regression analysis, there was an interaction of exposure to any lifetime DV, sexual violence and controlling behaviour, and counselling group with duration of breast-feeding at or before 6 months (P-interaction≤0·08). Among the UHM group, experience of any lifetime DV, sexual violence or controlling behaviour was associated with fewer days of EBF (P<0·05). In contrast, among the BFC group, experience of DV was not associated with duration of EBF. The experience of DV compromises EBF and the support of breast-feeding counselling programmes could assist this vulnerable group towards better infant feeding practices.
Biks, Gashaw Andargie; Berhane, Yemane; Worku, Alemayehu; Gete, Yigzaw Kebede
Despite the overall national success in reducing infant mortality rate in Ethiopia, infant mortality rate is still high in northwest Amhara region. This study is conducted in one of the high mortality areas with the aim of identifying risk factors that are associated with infant mortality in Northwest Amhara Region, Ethiopia. A prospective open cohort study involving 1752 infants (1472.4518 person years of follow-up) was undertaken from November 2009 to August 2011. Kaplan-Meier Survival analysis was used to estimate infant mortality rate. Risk factors associated with infant mortality were assessed using multivariate Poisson regression. The overall infant mortality rate was 88 per 1000 person-years (95% CI: 74.3, 104.9). After controlling other important predictors in multivariate Poisson regression, infants not exclusively breastfed [IRR = 7.86, 95% CI: (5.11, 12.10), )], breast milk initiated after 24 hours of birth [IRR = 4.84,95% CI: (2.94,7.99)], mothers not washing hands with soap after visiting toilet and before feeding child [IRR = 4.61, 95% CI: (2.24, 9.48)], being rural residents [IRR = 2.33, 95% CI: (1.12, 4.88)], infants born within 24 months for the previous birth [IRR = 2.79, 95%CI: (1.88, 4.15)], have increased the risk of infant mortality. In conclusion, exclusive breast feeding is the strongest predictor of infant survival in this predominantly rural setting where hygienic standards are poor. Supporting mothers to exclusively breast feeding which is cost effective, safe and feasible strategy, can help reduce infant mortality in the study setting.
Agarwal, Kailash Nath; Agarwal, Dev K; Gupta, Arti; Bansal, Ajay Kr
To assess if linear growth in infant is optimal, with exclusive breast feeding for 6 mo as advised by the WHO. This prospective follow up study included 71 full term babies of middle socio economic group healthy mothers. The mothers were instructed to breast feed the babies who were followed up to 18 mo of age for assessment of linear growth. The study was conducted in Metro General Hospital, Noida, U.P. Fifty six babies weighed ≥ 2.5 kg, and 15 babies weighed <2.5 kg at birth. The main outcome measure was linear growth in exclusively breast fed infants. At 18 mo, infants ≥ 2.5 kg on exclusive breast feeding for <6 mo and receiving semisolids early gained more length by 3.4 cm than those receiving breast feeding for ≥6 mo, and infant <2.5 kg gained more weight by 1.2 kg. For infants ≥ 2.5 kg of middle socioeconomic group, exclusive breast feed for 6 mo seems sufficient for optimal growth as compared to standard and reference growth data.
Rozga, Mary R; Kerver, Jean M; Olson, Beth H
Peer counselling (PC) programmes have been shown to improve breast-feeding outcomes in populations at risk for early discontinuation. Our objective was to describe associations between programme components (individual and combinations) and breast-feeding outcomes (duration and exclusivity) in a PC programme for low-income women. Secondary analysis of programme data. Multivariable-adjusted Cox proportional hazards models were used to examine associations between type and quantity of peer contacts with breast-feeding outcomes. Types of contacts included in-person (hospital or home), phone or other (e.g. mail, text). Quantities of contacts were considered 'optimal' if they adhered to standard programme guidelines. Programme data collected from 2005 to 2011 in Michigan's Breastfeeding Initiative Peer Counseling Program. Low-income (n 5886) women enrolled prenatally. For each additional home, phone and other PC contact there was a significant reduction in the hazard of discontinuing any breast-feeding by 6 months (hazard ratio (HR)=0·90 (95% CI 0·88, 0·92); HR=0·89 (95% CI 0·87, 0·90); and HR=0·93 (95% CI 0·90, 0·96), respectively) and exclusive breast-feeding by 3 months (HR=0·92 (95% CI 0·89, 0·95); HR=0·90 (95% CI 0·88, 0·91); and HR=0·93 (95% CI 0·89, 0·97), respectively). Participants receiving greater than optimal in-person and less than optimal phone contacts had a reduced hazard of any and exclusive breast-feeding discontinuation compared with those who were considered to have optimum quantities of contacts (HR=0·17 (95% CI 0·14, 0·20) and HR=0·28 (95% CI 0·23, 0·35), respectively). Specific components of a large PC programme appeared to have an appreciable impact on breast-feeding outcomes. In-person contacts were essential to improving breast-feeding outcomes, but defining optimal programme components is complex.
Yalçin, Siddika Songül; Berde, Anselm S; Yalçin, Suzan
The study aimed to provide an overall picture of the general pattern of exclusive breast feeding (EBF) in sub-Saharan Africa (SSA) by examining maternal sociodemographic, antenatal and postnatal factors associated with EBF in the region, as well as explore countries variations in EBF rates. We utilised cross-sectional data from the Demographic Health Surveys in 27 SSA countries. Our study sample included 25 084 infants under 6 months of age. The key outcome variable was EBF in the last 24 h. Due to the hierarchical structure of the data, a multilevel logistic regression model was used to explore factors associated with EBF. The overall prevalence of EBF in SSA was 36.0%, the prevalence was highest in Rwanda and lowest in Gabon. In the multilevel regression model, factors that were associated with increased likelihood of EBF included secondary and above maternal education, mothers within the ages of 25-34 years, rural residence, richer household wealth quantile, 4+ antenatal care visit, delivering in a health facility, singleton births, female infants, early initiation of breast feeding (EIBF), and younger infants. However, countries with higher gross national income per capita had lower EBF rates. To achieve a substantial increase in EBF rates in SSA, breast-feeding interventions and policies should target all women but with more emphasis to mothers with younger age, low educational status, urban residence, poor status, multiple births, and male infants. In addition, there is a need to promote antenatal care utilisation, hospital deliveries, and EIBF. © 2016 John Wiley & Sons Ltd.
Lutter, C K; Perez-Escamilla, R; Segall, A; Sanghvi, T; Teruya, K; Wickham, C
OBJECTIVES: This study examined the effectiveness of a hospital program to promote exclusive breast-feeding in Santos, Brazil. METHODS: In a prospective design, women who delivered at a hospital with an active breast-feeding promotion program (n = 236) were compared with women who delivered at a nearby control hospital (n = 206). RESULTS: The two groups had similar demographic characteristics and previous breast-feeding histories. Exposure to breast-feeding activities, assessed by maternal recall prior to discharge, was universally high at the program hospital and universally low at the control hospital. Multivariate survival analysis showed that exclusive breast-feeding lasted 53 days longer among women who delivered at the program hospital. CONCLUSIONS: Hospital-based breast-feeding promotion programs may be effective in extending the duration of exclusive breast-feeding. PMID:9146449
Smith, Hazel Ann; O'B Hourihane, Jonathan; Kenny, Louise C; Kiely, Mairead; Murray, Deirdre M; Leahy-Warren, Patricia
to investigate the influence of parental and infant characteristics on exclusive breast feeding from birth to six months of age and breast feeding rates at two, six and 12 months of age in Ireland. secondary data analysis from the Cork BASELINE Birth Cohort Study (http://www.baselinestudy.net/). Infants were seen at birth and two, six, and 12 months of age. Maternal and paternal history, neonatal course and feeding data were collected at birth and using parental questionnaires at each time point. 1094 singleton infants of primiparous women recruited at 20 weeks' gestation who were breastfeeding on discharge from the maternity hospital. at discharge from the maternity hospital and at two months, neonatal intensive-care unit admission had the strongest influence on exclusive breast feeding status (adjusted OR 0.17, 95% CI 0.07-0.41 at discharge) and at two months (adjusted OR=0.20, 95% CI 0.05-0.83). A shorter duration of breast feeding was significantly associated with younger maternal age, non-tertiary education, Irish nationality and neonatal intensive-care unit admission. There was a significant difference in the duration of any breast feeding between infants who were and were not admitted to the neonatal intensive-care unit, 28(10.50, 32) weeks versus 32(27, 40) weeks. Mothers whose maternity leave was between seven and 12 months (adjusted OR=2.76, 95% CI 1.51-5.05) breast fed for a longer duration compared to mothers who had less than six months of maternity leave. admission to the neonatal intensive care unit negatively influenced both exclusivity and duration of breast feeding. Length of maternity leave, and not employment status, was significantly associated with duration of breast feeding. additional support may be required to ensure continued breast feeding in infants admitted to the neonatal intensive-care unit. Length of maternity leave is a modifiable influence on breast feeding and offers the opportunity for intervention to improve our rates of breast
Mwiru, Ramadhani S; Spiegelman, Donna; Duggan, Christopher; Peterson, Karen; Liu, Enju; Msamanga, Gernard; Aboud, Said; Fawzi, Wafaie W
We examined the relationships between exclusive breast-feeding and the risks of respiratory, diarrhoea and nutritional morbidities during the first 2 years of life among children born to women infected with HIV-1. We prospectively determined the incidence of respiratory illnesses, diarrhoea, fever, hospitalizations, outpatient visits and nutritional morbidities. Generalized estimating equations were used to estimate the relative risks for morbidity episodes and Cox proportional hazards models to estimate the incidence rate ratios of nutritional morbidities. Dar es Salaam, Tanzania. The sample consisted of 666 children born to HIV-infected women. The 666 children were followed for 2 years. Exclusive breast-feeding was associated with lower risk for cough (rate ratio (RR) = 0·49, 95 % CI 0·41, 0·60, P < 0·0001), cough and fever (RR = 0·44, 95 % CI 0·32, 0·60, P < 0·0001) and cough and difficulty breathing or refusal to feed (RR = 0·31, 95 % CI 0·18, 0·55, P < 0·0001). Exclusive breast-feeding was also associated with lower risk of acute diarrhoea, watery diarrhoea, dysentery, fever and outpatient visits during the first 6 months of life, but showed no effect at 6-24 months of life. Exclusive breast-feeding did not significantly reduce the risks of nutritional morbidities during the first 2 years of life. Exclusive breast-feeding is strongly associated with reductions in the risk of respiratory and diarrhoea morbidities during the first 6 months of life among children born to HIV-infected women.
Mwiru, Ramadhani S; Spiegelman, Donna; Duggan, Christopher; Peterson, Karen; Liu, Enju; Msamanga, Gernard; Aboud, Said; Fawzi, Wafaie W
Objective We examined the relationships between exclusive breast-feeding and the risks of respiratory, diarrhoea and nutritional morbidities during the first 2 years of life among children born to women infected with HIV-1. Design We prospectively determined the incidence of respiratory illnesses, diarrhoea, fever, hospitalizations, outpatient visits and nutritional morbidities. Generalized estimating equations were used to estimate the relative risks for morbidity episodes and Cox proportional hazards models to estimate the incidence rate ratios of nutritional morbidities. Setting Dar es Salaam, Tanzania. Subjects The sample consisted of 666 children born to HIV-infected women. Results The 666 children were followed for 2 years. Exclusive breast-feeding was associated with lower risk for cough (rate ratio (RR) = 0·49, 95 % CI 0·41, 0·60, P < 0·0001), cough and fever (RR = 0·44, 95 % CI 0·32, 0·60, P < 0·0001) and cough and difficulty breathing or refusal to feed (RR = 0·31, 95 % CI 0·18, 0·55, P < 0·0001). Exclusive breast-feeding was also associated with lower risk of acute diarrhoea, watery diarrhoea, dysentery, fever and outpatient visits during the first 6 months of life, but showed no effect at 6–24 months of life. Exclusive breast-feeding did not significantly reduce the risks of nutritional morbidities during the first 2 years of life. Conclusions Exclusive breast-feeding is strongly associated with reductions in the risk of respiratory and diarrhoea morbidities during the first 6 months of life among children born to HIV-infected women. PMID:21324223
Tiwari, Ranjana; Mahajan, P C; Lahariya, Chandrakant
The actual rate of Exclusive Breast Feeding (EBF) (up to the age of 6 months) is dismally low in urban slums of India. The reasons and determinants of this are debatable. The study was planned to understand the determinants of EBF in the infants in urban slums. A community-based cross sectional study was done in urban slums of Gwalior, India. The data were collected by interviewing the caregivers of 279 infants aged between 6 and 11 months from November 2005 to July 2006. Only 11 (3.8%) mothers knew that EBF should be done till six months and 22 (7.8%) actually practiced EBF. A total of 178 (63.8%) and 212 (76.0%) newborns were given pre- and post-lacteal feeds with 26.2% discarding colostrum. Only 22 (7.8%) practiced EBF. The early breastfeeding (BF) initiation, Ante Natal Clinic (ANC) visits, mothers' education and immunization visits were significantly associated with higher probability of EBF. There were a number of myths and misconceptions about BF in this urban slum population. The correct information about BF was more common amongst the women who had frequent contacts with health facilities due to any reason or during ANC or immunization visit. Similarly, it is the continuum of good health and feeding practices and the mothers who start early BF or get their child immunized regularly are more likely to EBF their children. Considering the widely prevalent myths and low rate of utilization of health services along with high potential benefits of EBF, every opportunity of mothers' interaction with the health facility should be utilized for promoting correct and EBF practices.
Dimond, H J; Ashworth, A
Infant feeding practices of 6149 mothers in Kenya, Mexico and Malaysia are reported. A high proportion of mothers initiated breast-feeding in each country regardless of social class. Most Kenyan mothers continued to breast-feed for at least 12 months. In Mexico and Malaysia, however, breast-feeding was discontinued relatively early, especially among urban mothers. Early supplementation of breast-fed infants with milk and/or other food was a common practice in each of the three countries. Among breast-fed infants below 4 months of age, the percentages who were exclusively breast-fed in the urban elite, urban poor and rural groups respectively were 6, 14 and 21 per cent in Kenya, 8, 19 and 31 per cent in Mexico, and 11, 9 and 11 per cent in Malaysia. Supplementation of breast-fed infants in the first two months of life was more likely to be with infant formula than with any other milk or food. At three months of age, however, nonmilk foods were the most common supplements in all population groups with the exception of those in urban Kenya. The policy implications are discussed.
Eneroth, Hanna; El Arifeen, Shams; Persson, Lars-Ake; Kabir, Iqbal; Lönnerdal, Bo; Hossain, Mohammad Bakhtiar; Ekström, Eva-Charlotte
There is a concern that exclusive breast-feeding (EBF) for 6 mo may lead to iron and zinc deficiency in low-birth weight (LBW) infants. We assessed the association between duration of EBF and infant iron and zinc status in the Maternal and Infant Nutrition Interventions in Matlab trial, Bangladesh, stratified for normal birth weigh (NBW) and LBW. Duration of EBF was classified into EBF <4 mo and EBF 4-6 mo based on monthly recalls of foods introduced to the infant. Blood samples collected at 6 mo were analyzed for plasma zinc (n = 1032), plasma ferritin (n = 1040), and hemoglobin (Hb) (n = 791). Infants EBF 4-6 mo had a higher mean plasma zinc concentration (9.9 +/- 2.3 micromol/L) than infants EBF <4mo (9.5 +/- 2.0 micromol/L) (P < 0.01). This association was apparent in only the NBW strata and was not reflected in a lower prevalence of zinc deficiency. Duration of EBF was not associated with concentration of plasma ferritin, Hb concentration, or prevalence of iron deficiency or anemia in any strata. Regardless of EBF duration, the prevalence of zinc deficiency, iron deficiency, and anemia was high in infants in this population and strategies to prevent deficiency are needed.
Gunnarsdottir, Ingibjorg; Schack-Nielsen, Lene; Michaelsen, Kim Fleischer; Sørensen, Thorkild I A; Thorsdottir, Inga
To describe the association between duration of exclusive breast-feeding (EBF), weight gain in infancy and childhood BMI in two populations with a long duration of EBF. Cohort study with follow-up in childhood. Breast-feeding status was reported monthly during infancy. Weight and length were measured at birth, 2, 6 and 12 months of age, as well as in childhood at 6 or 10 years of age. Iceland and Denmark. Randomly selected healthy newborns from Denmark (n 85) and Iceland (n 100). Infants exclusively breast-fed for < or =2 months gained 348 (95% CI 69, 626) g more weight from 2 to 6 months than infants exclusively breast-fed for 3-4 months (P = 0.009). Weight gain from 6 to 12 months was found to be greater among infants exclusively breast-fed for < or =2 months compared with those exclusively breast-fed for > or =5 months (P = 0.008). A greater weight change, in terms of Z-score, between the ages of 2 and 6 months was associated with higher Z-score of childhood BMI, adjusted for birth weight, country and duration of EBF (B = 0.49, se = 0.11, P < 0.001, adj. R2 = 0.15). However, the association was much stronger in the Icelandic cohort than the Danish one. Although duration of EBF was not associated with childhood BMI in the present study it may modulate growth rate in infancy, which is related to childhood BMI. However, other factors determinative for infant growth also need to be considered when assessing the relationship of early growth and nutrition to childhood overweight, as traditions in complementary food might differ between populations.
Schluter, Philip J; Carter, Sarnia; Percival, Teuila
To present current breast-feeding rates for Pacific infants resident in New Zealand. Reasons for the introduction of complementary liquid foods were also explored. A longitudinal study using hospital discharge summary records and maternal home interviews undertaken at 6 weeks, 12 and 24 months postpartum. Turnbull's non-parametric survival analysis was used to model exclusive breast-feeding rates. Auckland, New Zealand. The cohort comprised 1376 infants at 6 weeks, 1223 infants at 12 months and 1142 infants at 24 months. Exclusive breast-feeding rates at hospital discharge, 6 weeks, 3 and 6 months postpartum were 84% (95% confidence interval (CI): 80-88%), 49% (95% CI: 43-55%), 37% (95% CI: 32-42%) and 9% (95% CI: 7-11%), respectively. Significant ethnic difference existed, with Samoan mothers having higher exclusive breast-feeding rates than Tongan mothers (P = 0.002). The percentage of infants receiving any breast milk at hospital discharge, 6 weeks, 12 and 24 months was 96% (95% CI: 94-97%), 95% (95% CI: 94-96%), 31% (95% CI: 28-34%) and 15% (95% CI: 13-17%), respectively. Again ethnic differences emerged. Common reasons cited for discontinuation of exclusive breast-feeding included uncertainty of breast milk supply (56%), problems with breasts (30%) and difficulties breast-feeding in work or educational environments (26%). However, 691 (50%) mothers sought no advice about their breast-feeding concerns within the first six weeks of life. Exclusive breast-feeding rates for Pacific infants are ethnically heterogeneous, have declined since the 1990s and fall short of the World Health Organization recommendations. The principal reasons cited for exclusive breast-feeding discontinuation echo those reported over a decade ago.
Background Despite the significant positive effect of exclusive breast-feeding on child health, only 32% of children under 6 months old were exclusively breast-fed in Kenya in 2008. The aim of this study was to explore perceptions and feeding practices of caregivers of children under 6 months old with special attention to the caregivers’ indigenous knowledge, perceptions about the health and nutritional problems of their infants, and care-seeking behaviors that affect feeding practices. Methods The study was exploratory and used an inductive approach. In all, 32 key informants, including mothers, mothers-in-law, and traditional healers, were interviewed in-depth. The number of participants in free-listing of perceived health problems of babies, in ranking of the perceived severity of these health problems, and in free-listing of food and drink given to children under 6 months old were 29, 28, and 32, respectively. Additionally, 28 babies under 6 months old were observed at home with regard to feeding practices. Data obtained using these methods were triangulated to formulate an ethnomedical explanatory model for mothers who do not practice exclusive breast-feeding. Results The informants stated that various types of food, drink, and medicine were given to infants under 6 months old. Direct observation also confirmed that 2- to 3-month-old babies were given porridge, water, juice, herbal medicine, and over-the-counter medicine. Mothers’ perceptions of insufficient breast milk production and a lack of proper knowledge about the value of breast milk were identified in key informant interviews, free-listing, and ranking as important factors associating with the use of food and drink other than breast milk; in addition, perceived ill health of babies appears to be associated with suboptimal practice of exclusive breast-feeding. Caregivers used various folk and popular medicines from the drugstore, their own backyard or garden, and traditional healers so that the
Matsuyama, Akiko; Karama, Mohamed; Tanaka, Junichi; Kaneko, Satoshi
Despite the significant positive effect of exclusive breast-feeding on child health, only 32% of children under 6 months old were exclusively breast-fed in Kenya in 2008. The aim of this study was to explore perceptions and feeding practices of caregivers of children under 6 months old with special attention to the caregivers' indigenous knowledge, perceptions about the health and nutritional problems of their infants, and care-seeking behaviors that affect feeding practices. The study was exploratory and used an inductive approach. In all, 32 key informants, including mothers, mothers-in-law, and traditional healers, were interviewed in-depth. The number of participants in free-listing of perceived health problems of babies, in ranking of the perceived severity of these health problems, and in free-listing of food and drink given to children under 6 months old were 29, 28, and 32, respectively. Additionally, 28 babies under 6 months old were observed at home with regard to feeding practices. Data obtained using these methods were triangulated to formulate an ethnomedical explanatory model for mothers who do not practice exclusive breast-feeding. The informants stated that various types of food, drink, and medicine were given to infants under 6 months old. Direct observation also confirmed that 2- to 3-month-old babies were given porridge, water, juice, herbal medicine, and over-the-counter medicine. Mothers' perceptions of insufficient breast milk production and a lack of proper knowledge about the value of breast milk were identified in key informant interviews, free-listing, and ranking as important factors associating with the use of food and drink other than breast milk; in addition, perceived ill health of babies appears to be associated with suboptimal practice of exclusive breast-feeding. Caregivers used various folk and popular medicines from the drugstore, their own backyard or garden, and traditional healers so that the mother or child would not be
Moraes, Claudia L; de Oliveira, Alessandra S D; Reichenheim, Michael E; Lobato, Gustavo
To investigate the role of severe physical violence during pregnancy (SPVP) between intimate partners in early cessation of exclusive breast-feeding (EBF). A health services survey. The revised Conflict Tactics Scale was used to characterize SPVP; premature breast-feeding cessation was identified using a current status data approach, which was based on the information reported from food recall during the preceding 7 d. The cumulative hazard function was estimated by complementary log-log transformation models, which allowed the ensuing estimation of early breast-feeding cessation rates in different age groups and the ratio of rates of weaning between women exposed and not exposed to violence. Five large public primary health-care facilities of Rio de Janeiro, Brazil. The sample comprised 811 randomly selected mothers of children under 5 months of age who were waiting to be consulted. SPVP is an independent risk factor of cessation of EBF since, after controlling for socio-economic, demographic, reproductive and lifestyle variables, women exposed to violence presented an incidence density that was 31% higher than those who were not exposed (hazard ratio = 1·30, 95% CI 1·01, 1·69). The findings corroborate the hypothesis that SPVP is an important risk factor for EBF. This indicates the need for incentives to adequately train health-care personnel in dealing with lactating women in order to gain a broader view of breast-feeding beyond the biological aspects of lactation, including the maternal psychological dimension.
International Children's Centre, Paris (France).
This set of documents consists of English, French, and Spanish translations of four pamphlets on breast-feeding. The pamphlets provide information designed for lay persons, academics and professionals, health personnel and educators, and policy-makers. The contents cover health-related differences between breast and bottle milk; patterns of…
Dewey, Kathryn G; Cohen, Roberta J; Brown, Kenneth H
There is little information on the risk of micronutrient deficiencies during the period of exclusive breast-feeding. We evaluated this among term, low-birthweight (LBW; 1500-2500 g) infants in Honduras. Mother-infant pairs were recruited in the hospital and assisted with exclusive breast-feeding during the first 4 mo. At 4 mo, infants were randomly assigned to either continue exclusive breast-feeding to 6 mo (EBF; n = 59) or be given iron-fortified complementary foods (rice, chicken, fruits, and vegetables) from 4 to 6 mo while continuing to breast-feed (SF, n = 60). Blood samples were collected at 2, 4, and 6 mo and analyzed for hemoglobin (Hb), hematocrit, plasma ferritin, % transferrin saturation, vitamin A, vitamin B-12, folate, zinc, and erythrocyte folate. Infants with Hb < 100 g/L at 2 or 4 mo were given medicinal iron supplements for 2 mo; the proportion administered iron drops did not differ significantly between groups. There was no significant effect of complementary foods on indices of vitamin A, B-12, folate, or zinc status. Among infants not given medicinal iron at 4-6 mo, iron status was higher in the SF group than the EBF group. In those given medicinal iron at 4-6 mo, iron status was higher in the EBF group, suggesting that complementary foods interfered with iron utilization. About half of the infants were anemic by 2 mo, before the age when complementary foods would be recommended. This supports the recommendation that LBW infants should receive iron supplementation in early infancy. Given that infants given iron supplements did not benefit from complementary foods at 4-6 mo, we conclude that exclusive breast-feeding for 6 mo (with iron supplementation) can be recommended for term, LBW infants.
Kramer, M S; Vanilovich, I; Matush, L; Bogdanovich, N; Zhang, X; Shishko, G; Muller-Bolla, M; Platt, R W
To study the effects of prolonged and exclusive breast-feeding on dental caries, we followed up children participating in the Promotion of Breastfeeding Intervention Trial (PROBIT), a cluster-randomized trial of a breast-feeding promotion intervention based on the WHO/UNICEF Baby-Friendly Hospital Initiative. A total of 17,046 healthy, mother-infant breast-feeding pairs were enrolled from 31 Belarussian maternity hospitals and affiliated polyclinics, of whom 13,889 (81.5%) were followed up at 6.5 years. At follow-up, polyclinic pediatricians transcribed the reports of a standard dental examination performed by public health dentists at age 6 years and recorded in the children's polyclinic charts. Analysis was based on intention to treat, with a statistical model that accounts for clustering within hospitals/clinics to permit inferences at the individual level. The experimental intervention led to a large increase in exclusive breast-feeding at 3 months (43.3 vs. 6.4%, p < 0.001) and a significantly higher prevalence of any breast-feeding at all ages up to and including 12 months. No significant intervention effects were observed on dental caries. Our results, based on the largest randomized trial ever conducted in the area of human lactation, provide no evidence of beneficial or harmful effects of prolonged and exclusive breast-feeding on dental caries at early school age.
Meinzen-Derr, Jareen K; Guerrero, M Lourdes; Altaye, Mekibib; Ortega-Gallegos, Hilda; Ruiz-Palacios, Guillermo M; Morrow, Ardythe L
The WHO recommends exclusive breast-feeding (EBF) for the first 6 mo of life to decrease the burden of infectious disease. However, some are concerned about the effect of EBF >6 mo on iron status of children in developing countries in which anemia is prevalent. This study examines the risk of anemia in relation to the duration of EBF and maternal anemia in a birth cohort studied between March 1998 and April 2003. All infant birth weights were >or=2.2 kg. All mothers received home-based peer counseling to promote EBF. Infant feeding data were collected weekly. Nurses measured hemoglobin (Hb) values every 3 mo. Hb was measured in 183 infants at 9 mo of age. Anemia at 9 mo was defined as a Hb value <100 g/L. EBF was defined by WHO criteria and ranged in duration from 0 to 31 wk. At 9 mo, Hb (mean +/- SEM) was 114 +/- 0.9 g/L; 23 children (12.5%) had Hb levels <100 g/L. EBF >6 mo, but not EBF 4-6 mo, was associated with increased risk of infant anemia compared with EBF <4 mo (odds ratio=18.4, 95% CI=1.9, 174.0). Maternal anemia was independently (P=0.03) associated with a 3-fold increased risk of infant anemia. These associations were not explained by confounding with other maternal or infant factors. By linear regression, a lower infant Hb at 9 mo was associated with increased EBF duration among mothers who had a history of anemia (beta=-0.07, P=0.003), but not among mothers with no history of anemia. Infants who are exclusively breast-fed for >6 mo in developing countries may be at increased risk of anemia, especially among mothers with a poor iron status; greater attention to this issue is warranted.
Martin, T C; Shea, M; Alexander, D; Bradbury, L; Lovell-Roberts, L; Francis, V
%) and sepsis neonatorum in 21/134 (16%). The hyperbilirubinaemia was idiopathic in 96/134 (71%) infants. Newborns in Antigua and Barbuda were discharged 3.7 days after their mothers' admission, with 50% discharged prior to 48 hours of age. Early discharge in developed countries has led to increased readmissions for hyperbilirubinaemia. Following the appointment of a dietitian to supervise breast-feeding, admissions for hyperbilirubinaemia fell by 50% by 1998. These data suggest that exclusive breast-feeding and early discharge led to an epidemic of neonatal hyperbilirubinaemia in Antigua and Barbuda.
Forman, M R; Fetterly, K; Graubard, B I; Wooton, K G
Questions about infant feeding practices after birth were included in 1969 and 1980 National Natality Surveys (NNS). At 3-6 mo postpartum, NNS questionnaires were mailed to mothers of live infants born in wedlock, and responses were weighted to permit national estimates. Based on the NNS, the proportion of women who were exclusively breast-feeding newborns in the United States was significantly lower in 1969 (19% of white women, 9% of black women) compared with 1980 (51% of white women, 25% of black women). In 1969, the highest percentages of exclusive breast-feeding were observed among white women less than or equal to 34 yr, of parity less than or equal to 3 and greater than 7, and of higher than lower socioeconomic groups; and among black women greater than or equal to 30 yr, of parity greater than or equal to 4, and of lower than higher socioeconomic groups. Among women in both races in 1980, more primiparae than multiparae and the more highly educated were breast-feeding. More white than black women exclusively breast-fed within each birthweight and each sociodemographic characteristic in 1980; therefore, the racial differences remained across these factors. These findings are compared with results of the Ross Laboratories surveys of infant feeding.
Ochola, Sophie A; Labadarios, Demetre; Nduati, Ruth W
To determine the impact of facility-based semi-intensive and home-based intensive counselling in improving exclusive breast-feeding (EBF) in a low-resource urban setting in Kenya. A cluster randomized controlled trial in which nine villages were assigned on a 1:1:1 ratio, by computer, to two intervention groups and a control group. The home-based intensive counselling group (HBICG) received seven counselling sessions at home by trained peers, one prenatally and six postnatally. The facility-based semi-intensive counselling group (FBSICG) received only one counselling session prenatally. The control group (CG) received no counselling from the research team. Information on infant feeding practices was collected monthly for 6 months after delivery. The data-gathering team was blinded to the intervention allocation. The outcome was EBF prevalence at 6 months. Kibera slum, Nairobi. A total of 360 HIV-negative women, 34-36 weeks pregnant, were selected from an antenatal clinic in Kibera; 120 per study group. Of the 360 women enrolled, 265 completed the study and were included in the analysis (CG n 89; FBSICG n 87; HBICG n 89). Analysis was by intention to treat. The prevalence of EBF at 6 months was 23.6% in HBICG, 9.2% in FBSICG and 5.6% in CG. HBICG mothers had four times increased likelihood to practise EBF compared with those in the CG (adjusted relative risk = 4.01; 95% CI 2.30, 7.01; P=0.001). There was no significant difference between EBF rates in FBSICG and CG. EBF can be promoted in low socio-economic conditions using home-based intensive counselling. One session of facility-based counselling is not sufficient to sustain EBF.
... breast-feed more than one baby? Here's help breast-feeding twins or other multiples, from getting positioned and ensuring an adequate milk supply to combining breast-feeding and formula-feeding. By Mayo Clinic Staff If ...
García-López, María Antonia; Ros-Bas, Olga
To determine the prevalence of exclusive breastfeeding (EBF) in a Basic Health Area, and the maternal factors and socio-cultural perinatal problems related to the initiation and maintenance of the EBF. Observational, cross-sectional study. The study was carried out in Mazarrón Health Center (Cartagena Primary Care Management, Area II, Murcia).The participants of the study were all the children born between 11/01/2004 and 11/30/2005 along with their mothers (236 children overall). The study consisted of an interview that was conducted by a nurse during the 15 months check-up. The questionnaire was made up of thirteen questions including, sex, race, place of birth, weight, birth weight, prematurity, number of siblings (Perinatal care variables), and others, such as, age, number of children, nationality, education and occupation ( maternal variables) and one question on the number of EBF months. Those children who did not attend the health center and those who were not found during the data collection period did not participate in the research. The number of mothers who responded to the questionnaire was 89.8% (212). The prevalence at the beginning of EBF is 75.4% (156) of all children. The average length of EBF is 2.99 months. The average maternal age is 31.26 years. The percentage of mothers who did not work was 45.9% (89). The lowest percentage of EBF is found in premature boys born by caesarean. Maternal origin positively influences EBF. The women with the greatest breastfeeding capacities are African. Both the prevalence at home and the average length of the EBF in the Health Area are high; the most influencing maternal factors are maternal origin and the type of childbirth. Copyright 2009 Elsevier España, S.L. All rights reserved.
Breast-feeding has always been perceived as a contraceptive measure, probably because it is associated with amenorrhea. However, many pregnancies occur during breast-feeding, often quite soon after delivery. A pregnancy occurring 3 months after delivery is considered at risk for both the mother and child. Three conditions are necessary for a 98% contraceptive efficacy of lactation: total amenorrhea; exclusive breast-feeding on demand, both day and night; and occurrence within the first 6 months postpartum. If the three conditions are met, no additional contraceptive method is needed. Beyond 6 months, another method should be used.
Hanieh, Sarah; Ha, Tran T; Simpson, Julie A; Thuy, Tran T; Khuong, Nguyen C; Thoang, Dang D; Tran, Thach D; Tuan, Tran; Fisher, Jane; Biggs, Beverley-Ann
Acute respiratory infections and diarrhea remain the leading causes of infant morbidity and mortality, with a high burden of both pneumonia and diarrhea in South-East Asia. The aim of the study was to determine antenatal and early infant predictive factors for severe morbidity episodes during the first 6 months of life in Ha Nam province, Vietnam. A prospective cohort study of 1049 infants, born to women who had previously participated in a cluster randomized controlled trial of antenatal micronutrient supplementation in rural Vietnam, was undertaken between 28th September 2010 and 8th Jan 2012. Infants were followed until 6 months of age, and the outcome measure was inpatient admission for suspected pneumonia or diarrheal illness during the first 6 months of life. Risk factors were assessed using univariable logistic regression and multiple logistic regression. Of the 1049 infants seen at 6 months of age, 8.8 % required inpatient admission for suspected pneumonia and 4 % of infants required inpatient admission for diarrheal illness. One third of infants (32.8 %) were exclusively breast fed at 6 weeks of age. Exclusive breast feeding at 6 weeks of age significantly reduced the odds of inpatient admission for suspected pneumonia (Odds Ratio (OR) 0.39, 95 % Confidence Interval (CI) 0.20 to 0.75) and diarrheal illness (OR 0.37, 95 % CI 0.15 to 0.88). Exclusive breast feeding in early infancy reduces the risk of severe illness from diarrhea and suspected pneumonia. Public health programs to reduce the burden of inpatient admission from diarrheal and respiratory illness in rural Vietnam should address barriers to exclusive breast feeding.
Bhatta, Dharma Nand
Men in patriarchal societies of developing countries are often identified as decision makers in all aspects of day-to-day life. The study explores the factors associated with male involvement in ANC, birth plans, exclusive breastfeeding and immunization of children. A cross-sectional survey was conducted among 2178 married males between May and December 2010 in Kathmandu, Nepal. Twenty one clusters were selected for data collection using structured questionnaire. Adjusted odds ratios (AORs) and 95% confidence intervals (95% CI) of associated factors were estimated by stepwise backward likelihood ratio method. This study determined the percentage of males who accompanied their partners for ANC (39.3%), arranged SBA (47.9%) and accompanied them for child immunization (10.9%). Factors found associated with respect to different activities were as follows: accompanied their partners on antenatal visits - uneducated or primary level education (AOR, 5.68, 95% CI, 4.44-7.27), income NPR 5001 (1USD = 85 NPR) or above (1.47, 1.20-1.80) and aged above 25 years (2.51, 1.89-3.33); arranged money for delivery - uneducated or primary level education (7.34, 5.84-9.23), income NPR 5001 or above (1.80, 1.48-2.20) and aged above 25 years (1.55, 1.18-2.03); arranged SBA - uneducated or primary level education (17.14, 12.65-23.22) and income NPR 5001 or above (2.89, 2.36-3.54); arranged transportation - uneducated or primary level education (17.65, 11.84-26.32), income NPR 5001 or above (1.69, 1.40-2.04) and aged above 25 years (1.69, 1.27-2.24); encouraged exclusive breast feeding - uneducated or primary level education (5.48, 4.39-6.83) and aged above 25 years (1.35, 1.03-1.77); accompanied their partners for immunization their children - uneducated or primary level education (3.88, 2.53-5.96) and aged above 25 years (1.72, 1.11-2.64). Men who were uneducated or had primary level education, aged above 25 years, had higher income, formal employment, came from Hindu religion and non
Background Men in patriarchal societies of developing countries are often identified as decision makers in all aspects of day-to-day life. The study explores the factors associated with male involvement in ANC, birth plans, exclusive breastfeeding and immunization of children. Methods A cross-sectional survey was conducted among 2178 married males between May and December 2010 in Kathmandu, Nepal. Twenty one clusters were selected for data collection using structured questionnaire. Adjusted odds ratios (AORs) and 95% confidence intervals (95% CI) of associated factors were estimated by stepwise backward likelihood ratio method. Results This study determined the percentage of males who accompanied their partners for ANC (39.3%), arranged SBA (47.9%) and accompanied them for child immunization (10.9%). Factors found associated with respect to different activities were as follows: accompanied their partners on antenatal visits – uneducated or primary level education (AOR, 5.68, 95% CI, 4.44-7.27), income NPR 5001 (1USD = 85 NPR) or above (1.47, 1.20-1.80) and aged above 25 years (2.51, 1.89-3.33); arranged money for delivery – uneducated or primary level education (7.34, 5.84-9.23), income NPR 5001 or above (1.80, 1.48-2.20) and aged above 25 years (1.55, 1.18-2.03); arranged SBA – uneducated or primary level education (17.14, 12.65-23.22) and income NPR 5001 or above (2.89, 2.36-3.54); arranged transportation – uneducated or primary level education (17.65, 11.84-26.32), income NPR 5001 or above (1.69, 1.40-2.04) and aged above 25 years (1.69, 1.27-2.24); encouraged exclusive breast feeding – uneducated or primary level education (5.48, 4.39-6.83) and aged above 25 years (1.35, 1.03-1.77); accompanied their partners for immunization their children – uneducated or primary level education (3.88, 2.53-5.96) and aged above 25 years (1.72, 1.11-2.64). Conclusions Men who were uneducated or had primary level education, aged above 25 years, had higher
Giwercman, Charlotte; Halkjaer, Liselotte B; Jensen, Signe Marie; Bønnelykke, Klaus; Lauritzen, Lotte; Bisgaard, Hans
Breast-feeding is recommended for the prevention of eczema, asthma, and allergy, particularly in high-risk families, but recent studies have raised concern that this may not protect children and may even increase the risk. However, disease risk, disease manifestation, lifestyle, and the choice to breast-feed are interrelated, and therefore, analyzing true causal effects presents a number of methodologic challenges. First, to assess the effect from duration of exclusive breast-feeding on the development of eczema and wheezy disorders during the first 2 years of life in a high-risk clinical birth cohort. Second, to assess any influence from the fatty acid composition of mother's milk on the risk from breast-feeding. We studied disease development during the first two years of life of the 411 infants from the Copenhagen Study on Asthma in Childhood (COPSAC) birth cohort, born to mothers with a history of asthma. We analyzed the effect from duration of breast-feeding before disease onset on the disease risk, avoiding the effect from disease-related modification of exposure (inverse causation). Polyunsaturated fatty acids were measured in breast milk. Breast-feeding significantly increased the risk of eczema adjusted for demographics, filaggrin variants, parents' eczema, and pets at home (N = 306; relative risk, 2.09; 95% CI 1.15-3.80; P = .016) but reduced the risk of wheezy episodes (relative risk, 0.67; 95% CI 0.48-0.96; P = .021) and of severe wheezy exacerbation (relative risk, 0.16; 95% CI 0.03-1.01; P = .051). There was no association between the fatty acid composition of mother's milk and the risk of eczema or wheeze. The risk of eczema was increased in infants with increasing duration of breast-feeding. In contrast, the risk of wheezy disorder and severe wheezy exacerbations was reduced. There were no significant effects from the fatty acid composition of the breast milk on risk of eczema or wheezy disorders. Copyright (c) 2010 American Academy of Allergy
A Cross-sectional Descriptive Study was to Estimate the Prevalence of the Early Initiation of and Exclusive Breast Feeding in the Rural Health Training Centre of a Medical College in Tamilnadu, South India.
Jennifer, H Gladius; Muthukumar, K
The World Health Organization and the National guidelines on infant and young child feeding recommend the practice of exclusive breastfeeding of infants for the first 6 months after their birth. The objective of this study was to estimate the prevalence of the early initiation of and exclusive breast feeding. A cross sectional, descriptive study was done. 79 infants and children who attended the under five clinic in the Rural Health Training Centre (RHTC), Pulipakkam Village, were chosen for the study by convenient sampling. This study was conducted by interviewing 79 mothers of the children in the ages of 0-24 months, who attended the under five clinic of RHTC, Pulipakkam. The data was collected by using a pre tested, structured questionnaire to obtain the information on the breast feeding and the hygienic feeding practices among mothers. The statistical analysis was done by the authors by using the SPSS, version 16. The significance in the differences were evaluated by using the Chi square test and the relationship between the variables were evaluated by using Kendall's tau correlation. A p value of <0.05 was considered as statistically significant. The prevalence of the early Initiation of breast feeding was 97.5% and the prevalence of exclusive breast feeding in the study population was 68%. Inadequate exclusive breast feeding and the lack of hygienic feeding practices among the mothers were significantly associated with an increased incidence of upper and lower respiratory tract infections and gastro intestinal infections in the infants and the children. The education of the antenatal mothers on the benefits of breast feeding and hygienic feeding practices and making all hospitals baby friendly have to be focused on, in order to achieve 80% exclusive breast feeding as per the national guidelines on infant and young child feeding. We need to strengthen the MCH services in the study area in order to achieve 100% immunization.
One of the greatest advantages of feeding exclusively breast-milk is the continuous provision of immunoglobulin A, especially during the first days of life, and of leucocytes with macrophage function as well as unspecific, antiinfectious agents like lactoferrin, lysozyme and neuraminic acid. It seems, that the organism is protected against allergic reactions at the mucosa level of the small intestine caused by the penetration of "foreign" protein by feeding exclusively breast-milk especially during the first weeks and months of life. During the first months of the infant's life an increased supply of iron results from the higher content of iron in breast-milk as compared to cow's milk, and the better absorption of the iron from breast-milk. Just because of this (the better provision with iron from natural food) solid foods should not be added to the infant's diet before 6 months of age. One of the disadvantages of breast-feeding is the passage of unwanted substances from breast-milk to the infant. First of all the chlorinated hydrocarbons have to be mentioned within this context. However, a decreasing tendency can be assumed according to recent investigations. An increasing tendency in breast-milk, though not confirmed, seems possible only for the polychlorinated biphenyls. Nevertheless, for the pediatrician no reason to advise against breast-feeding results from the unwanted admixtures of chlorinated hydrocarbons in breast-milk. One should rather vigorously propagate to feed as many children as possible exclusively with breast-milk over a period of 4 to 6 months.
Tuthill, Emily L; Butler, Lisa M; Pellowski, Jennifer A; McGrath, Jacqueline M; Cusson, Regina M; Gable, Robert K; Fisher, Jeffrey D
Exclusive breast-feeding (EBF) provides optimal nutrition for infants and mothers. The practice of EBF while adhering to antiretroviral medication decreases the risk of mother-to-child transmission of HIV from approximately 25 % to less than 5 %. Thus the WHO recommends EBF for the first 6 months among HIV-infected women living in resource-limited settings; however, EBF rates remain low. In the present study our aim was to design and implement a pilot intervention promoting EBF among HIV-infected women. The Information-Motivation-Behavioural Skills (IMB) model was applied in a brief motivational interviewing counselling session that was tested in a small randomized controlled trial. Pietermaritzburg, South Africa, at two comparable rural public health service clinics. Sixty-eight HIV-infected women in their third trimester were enrolled and completed baseline interviews between June and August 2014. Those randomized to the intervention arm received the IMB-based pilot intervention directly following baseline interviews. Follow-up interviews occurred at 6 weeks postpartum. While not significantly different between trial arms, high rates of intention and practice of EBF at 6-week follow-up were reported. Findings showed high levels of self-efficacy being significantly predictive of breast-feeding initiation and duration regardless of intervention arm. Future research must account for breast-feeding self-efficacy on sustaining breast-feeding behaviour and leverage strategies to enhance self-efficacy in supportive interventions. Supporting breast-feeding behaviour through programmes that include both individual-level and multi-systems components targeting the role of health-care providers, family and community may create environments that value and support EBF behaviour.
Afzal, Muhammad; Quddusi, Ahmed Iqbal; Iqbal, Mudassir; Sultan, Mehboob
To determine the status of breast feeding, exclusive breast feeding and other feeding patterns in infants upto 12 months age. Cross- sectional study. Paediatrics Department and Immunization Center, Combined Military Hospital, Multan, from October 2004 to March 2005. This study was based on "current status analysis method" to eliminate the bias of recall method used in most previous studies. Mothers of 650 infants from 0-12 months of age, attending immunization centre and paediatrics OPD, were interviewed about current feeding patterns and other socioeconomic variables. They were divided in three groups depending upon their monthly income. Living conditions matched with monthly income status in all groups. Month-wise distribution of feeding pattern was determined. Analysis was made about the effect of education of mothers, family income, place and mode of delivery, gender of the baby on exclusive breast feeding, duration of breast feeding and initiation of breast feeding. Statistical analysis of the results was made by application of Parson's Chi-square test. Breast feeding was maintained at high level (more than 88%) throughout infancy. Exclusive breast feeding was also maintained at quite high level (66%) till 4 month age. But later there was a sharp decline to 16% at six months of age. The median duration of exclusive breast feeding was 3 months. Mothers with lesser education and lower family income were more likely to exclusively breast feed (p < 0.001). The time interval between birth and first feed observed was quite desirable (less than 3 hours) in most cases. Only 14% infants received pre-lacteal feeds (ghutti, honey, water etc.), while majority of them (59%) received breast milk. Formula milk was first feed in only 25% cases. Breast milk as first and early feed was observed more in babies born by normal delivery in hospital (p < 0.001). Status of breast feeding, exclusive breast feeding and other feeding practices was quite encouraging and desirable in this
Zohoori, N; Popkin, B M; Fernandez, M E
Data from the Cebu Longitudinal Health and Nutrition Survey have been used to examine breast-feeding patterns in the Metropolitan Cebu region of the Philippines. The results show that there is extensive and early use of non-nutritive liquids, resulting in low levels of exclusive breast-feeding. The use of cross-sectional versus longitudinal data, the definition of exclusive breast-feeding, and movements in and out of the exclusively breast-fed category, are considered.
Manji, Karim P; Duggan, Christopher; Liu, Enju; Bosch, Ronald; Kisenge, Rodrick; Aboud, Said; Kupka, Ronald; Fawzi, Wafaie W
The jury on transmission of HIV through breast-feeding is still on. Data from a clinical trial in children born to HIV-positive mothers were evaluated with respect to their relationship to mother-to-child transmission. A total of 1629 infants who were not infected at age 6 weeks, had HIV results available at 12 months and who were breast-fed were included in this study. Exclusive breast feeding (EBF) rates declined from 85% at 2 months to < 30% by 4 months. EBF was associated with a sustained and significant reduction in HIV infection. With every incremental month of EBF, HIV infection was reduced by 16% [multivariable (risk ratio) RR: 0.84, CI: 0.72-0.98, p = 0.03] from enrollment to 6 months of age and by 18% (multivariable RR: 0.82, CI: 0.72-0.94, p = 0.005) from enrollment to 12 months of age. EBF significantly reduces the risk of vertical HIV transmission through 12 months of age. © The Author . Published by Oxford University Press. All rights reserved. For Permissions, please email: firstname.lastname@example.org.
Becquet, Renaud; Ekouevi, Didier K.; Viho, Ida; Sakarovitch, Charlotte; Toure, Hassan; Castetbon, Katia; Coulibaly, Nacoumba; Timite-Konan, Marguerite; Bequet, Laurence; Dabis, François; Leroy, Valériane
Objective We assessed the uptake of a nutritional intervention promoting exclusive breastfeeding with early cessation between three and four months of age to reduce postnatal transmission of HIV in Abidjan, Côte d’Ivoire. Design Between March 2001 and March 2003, HIV infected pregnant women who had received a perinatal antiretroviral prophylaxis were systematically offered prenatally two infant feeding interventions: either artificial feeding, or exclusive breastfeeding during three months then early cessation of breastfeeding. Mother-infant pairs were closely followed for a period of two years, with continuous nutritional counseling and detailed collection of feeding practices. Results Among the 557 mothers enrolled, 262 (47%) initiated breastfeeding. Of these women, the probability of practicing exclusive breastfeeding from birth was 18% and 10% at one and three months of age, respectively. Complete cessation of breastfeeding was obtained in 45% and 63% by four and six months of age, respectively. Environmental factors such as living with partner’s family were associated with failure to initiate early cessation of breastfeeding. Conclusions Acceptability of exclusive breastfeeding was low in this urban population. However, shortening the duration of breastfeeding appeared to be feasible. Further investigations are ongoing to fully evaluate the safety and effectiveness of this intervention in reducing breastmilk HIV transmission. PMID:16284538
MacDonald, A; Depondt, E; Evans, S; Daly, A; Hendriksz, C; Chakrapani A, A; Saudubray, J-M
Breast feeding has proven benefits for many infants with inherited metabolic disorders (IMDs) but, with the exception of phenylketonuria, there are few reports in other conditions. A questionnaire, completed by dietitians and clinicians from 27 IMD centres from 15 countries (caring for a total of over 8000 patients with IMDs on diet) identified breast feeding experience in IMD. Successful, demand breast feeding (in combination with an infant amino acid formula free of precursor amino acids) was reported in 17 infants with MSUD, 14 with tyrosinaemia type I, and 5 with homocystinuria. Eighty-nine per cent were still breast fed at 16 weeks. Fewer infants with organic acidaemias were demand breast fed (7 with propionic acidaemia; 6 with methylmalonic acidaemia and 13 with isovaleric acidaemia) (usually preceded by complementary feeds of a protein-free infant formula or infant amino acid formula free of precursor amino acids). Only 12 infants with urea cycle disorders were given demand breast feeds, but this was unsuccessful beyond 8 days in CPS deficiency. Further work is needed in developing guidelines for feeding and for clinical and biochemical monitoring for breast-fed infants with IMDs.
Giashuddin, M S; Kabir, M
The duration of exclusive breast-feeding in Bangladesh is low. Though several studies have been carried out on breast-feeding in Bangladesh, the factors influencing the duration of breast-feeding are not studied. The purpose of this study was to assess the duration of breast-feeding among children in Bangladesh and to study socio-economic and demographic factors affecting the duration. The study included 5068 mother-child pairs, selected on the basis of Bangladesh Demographic Health Survey (BDHS) of 1999-2000. The risk of giving supplementary food at different ages was estimated by life table survival method. Independent effects of total duration of breast-feeding of each of the study variables were estimated by using Cox's regression model. The median duration of full breast-feeding was 3.67 months whereas mean and median durations of total breast-feeding was 31.3 and 30 months respectively. Life table analysis showed that 69.9 per cent women gave supplementary food to their babies before reaching six months of age. Cox's regression analysis revealed that women who had lived in rural areas were less likely to terminate breast-feeding than those living in urban areas. Women who had completed at least secondary education were more likely to stop breast-feeding than less or uneducated mothers. Children born in high economic status families had higher risk of stopping breast-feeding compared to those in low economic status families. Further, the deliveries assisted by the relatives had lower risk of terminating breastfeeding than by the health professionals. According to the study results, women with higher education, high economic level, lower birth interval and delivery assisted by health personnel had lower duration of breastfeeding. Future breast-feeding programme in Bangladesh should give special attention to these women since they breast-feed relatively shorter periods of time.
only about 25% of babies are exclusively breast fed until six months of age in developing countries and, given their greater risk of infection and infant mortality, there is a need to investigate ways of increasing this. The aim of this review is to assess the effectiveness of community-based interventions to improve the rates of exclusive breast feeding at four to six months in infants in low- and low-middle-income countries. a systematic review of literature identified through searches of Medline, Global Health and CINAHL databases to identify randomised controlled trials of community-based interventions to improve the rate of exclusive breast feeding in low- and low-middle-income countries. four studies, from four different countries, were included in the final review. Although they evaluated slightly different interventions, all showed a significant improvement in the rate of exclusive breast feeding with a pooled odds ratio of 5.90 (95% confidence interval 1.81-18.6) on random effects meta-analysis. community-based interventions in low- and low-middle-income countries can substantially increase the rates of exclusive breast feeding and are therefore a viable option. The interventions included in the review varied, indicating that there are a number of ways in which this might be achieved; it is recommended that these are used as a starting point for determining the most appropriate intervention with regard to the setting. Given the importance of this issue, the lack of research in the area is surprising. The studies in the review demonstrate that good-quality randomised controlled trials of this area are possible and should encourage further research. Copyright © 2010 Elsevier Ltd. All rights reserved.
Marquis, Grace S; Lartey, Anna; Perez-Escamilla, Rafael; Mazur, Robert E; Brakohiapa, Lucy; Birks, Katherine A
Exclusive breast-feeding (EBF) for 6 months supports optimal infant growth, health and development. This paper examined whether maternal HIV status was associated with EBF and other infant feeding practices. Pregnant women were enrolled after HIV counselling, and their babies were followed up for up to 1 year. Data on household socio-economics and demographics, maternal characteristics and infants' daily diet were available for 482 infants and their mothers (150 HIV-positive (HIV-P), 170 HIV-negative (HIV-N) and 162 HIV-unknown (HIV-U)). Survival analyses estimated median EBF duration and time to introduction of liquids and foods; hazards ratios (HR) used data from 1-365 and 1-183 d, adjusting for covariates. Logistic regression estimated the probability of EBF for 6 months. Being HIV-P was associated with a shorter EBF duration (139 d) compared with HIV-N (163 d) and HIV-U (165 d) (P=0·004). Compared with HIV-N, being HIV-P was associated with about a 40 % higher risk of stopping EBF at any time point (HR 1·39; 95 % CI 1·06, 1·84; P=0·018) and less than half as likely to complete 6 months of EBF (adjusted OR 0·42; 95 % CI 0·22, 0·81; P=0·01). Being HIV-P tended to be or was associated with a higher risk of introducing non-milk liquids (HR 1·34; 95 % CI 0·98, 1·83; P=0·068), animal milks (HR 2·37; 95 % CI 1·32, 4·24; P=0·004) and solids (HR 1·56; 95 % CI 1·10, 2·22; P=0·011) during the first 6 months. Weight-for-age Z-score was associated with EBF and introducing formula. Different factors (ethnicity, food insecurity, HIV testing strategy) were associated with the various feeding behaviours, suggesting that diverse interventions are needed to promote optimal infant feeding.
Chezem, Jo Carol
The goals of the study were to describe maternal and paternal attitudes toward breastfeeding among couples planning exclusive breastfeeding and those planning mixed feeding and to compare maternal predictions of paternal attitudes with actual paternal attitudes. Expectant parents with the intention to breastfeed were recruited from outpatient clinics. During the third trimester of pregnancy, mothers and fathers independently completed a demographic questionnaire and a breastfeeding attitude survey. In addition, mothers were asked to predict fathers' attitudes. Seventy-one subjects completed all study requirements: 56 planned to exclusively breastfeed, and 15 planned to mix feed. The majority of subjects were white, educated beyond high school, and married. Expectant parents planning to exclusively breastfeed were significantly more likely to report higher paternal age (p=0.019), higher maternal age (p=0.006), and higher maternal education (p=0.023) than those planning to mix feed. Among fathers, those planning exclusive breastfeeding expressed more favorable attitudes related to naturalness (p=0.009) and closeness (p=0.036) than their mixed-feeding peers. Compared with mothers planning mixed feeding, those planning exclusive breastfeeding indicated more favorable attitudes related to naturalness (p=0.006) and respect for breastfeeding women (p=0.005). Overall, mothers reported more favorable attitudes toward breastfeeding than fathers in several areas, including disease protection (p=0.004), respect for breastfeeding women (p=0.043), and naturalness (p=0.011). The mother's predictions were less favorable than the father's actual attitudes in the areas of purpose of breasts (p=0.007), respect (p=0.049), and closeness (p=0.024). Results suggest expectant parents who plan to mix feed may be fundamentally different from those planning to exclusively breastfeed. There is a continued need to identify factors that influence the prenatal decision to mix feed and to develop
Whitehead, R G; Paul, A A
The present paper reviews the research of the authors and their colleagues over the past 20 years to provide improved nutritional and anthropometric guidelines for the assessment of lactational adequacy and for when the weaning process might be initiated. The nutritional guidelines are based on revised dietary energy requirements. The basic assumption is that since breast milk is a well-balanced food, if energy needs are satisfied so will those for essential nutrients. Energy requirements for young babies have been derived from the application of the doubly-labelled-water technique. This approach indicated that 460 kJ (110 kcal)/kg per d at 1 month and 397 and 355 kJ (95 and 85 kcal)/kg per d at 3 and 6 months respectively would be satisfactory for a nutrient content of high bioavailability. Translated into a breast-milk intake of 850 ml/d the latter would cover the dietary energy needs of the average child growing along the 50th centile until at least 4 months, but the typical child from many developing countries following the 25th centile until 6 months. The importance of revised growth reference values for infancy, equally crucial for assessing lactational adequacy, is also reviewed. In contrast with the shapes of earlier reference patterns, growth trajectories are different when babies are fed in accordance with modern paediatric advice. Mothers and health professionals using the older growth charts to assess the progress of a baby can be misled into assuming that the weaning process needs to be introduced sooner than necessary. Examples of this situation within the context of a developing country are provided.
Sadoh, A E; Sadoh, W E; Oniyelu, P
BACKGROUND: Health care workers are important in the promotion, protection and support of breast feeding. Their ability to do this may be influenced by their knowledge, personal experiences and work. PATIENTS AND METHOD: The breast feeding experience of 36 female medical doctors who had babies within the preceding two years and had resumed work was evaluated using a semi-structured self administered questionnaire. RESULT: All respondents knew that babies should be exclusively breast fed for the first six months of life but only 60% knew that breast feeding should continue until two years. The exclusive breast feeding rate for the studied doctors was 11.1%. Before their babies were six months old, about 75% of respondents had resumed work whilst over 50% had started taking calls. Most could not breast feed during working or call hours. Alternative feeds during working or call hours included expressed breast milk in 34.4% and infant formula in 21.9%. Feeding bottle was the major method (77.4%) for feeding these alternatives. Work schedule was rearranged to allow breast feeding in only 27.3% of respondents. CONCLUSION: Failure to carry out exclusive breast feeding, the use of infant formula and feeding bottles (rather than cup feeding) are practices that may be inimical to the practice of breast feeding in society in general. The suboptimal breast feeding experience in these doctors and the identified knowledge deficits may limit their effectiveness in promoting and supporting breast feeding among their patients and communities. Female medical personnel should be empowered to carry out optimal feeding of their own infants.
Lowe, Adrian J; Carlin, John B; Bennett, Catherine M; Abramson, Michael J; Hosking, Clifford S; Hill, David J; Dharmage, Shyamali C
A number of studies have observed an association between breast-feeding and increased risk of development of asthma and eczema. It has been proposed that these results might be due to early signs of atopic disease in the infant causing mothers to prolong breast-feeding. We sought to determine whether early symptoms of atopic disease (eczema, food reaction, or asthma) or positive skin prick test responses reduce the likelihood of ceasing breast-feeding. A prospective birth cohort of 620 infants from Melbourne, Australia, was used. Telephone interviews every 4 weeks were conducted until 64 weeks and then again at 78 and 104 weeks to determine duration of breast-feeding (both exclusive and total) and evidence of atopic disease. Because of the varying time of onset of atopic symptoms, they were modeled as time-varying covariates in Cox models. Only 52 (8.4%) infants did not establish breast-feeding, whereas an additional 103 (25.0%) did not establish exclusive breast-feeding. Early signs of atopic disease or sensitization were independently associated with an approximately 28% reduction in risk of ceasing exclusive breast-feeding (adjusted hazard ratio, 0.72; 95% CI, 0.53-0.97); P=.029), but there was no evidence for a relationship with risk of ceasing breast-feeding completely (adjusted hazard ratio, 1.12; 95% CI, 0.92-1.37; P=.262). Early signs of atopic disease might prolong the duration of exclusive breast-feeding. This could mask a protective effect of breast-feeding or even result in breast-feeding appearing to be a risk factor for the development of atopic diseases. Future investigation of the relationship between breast-feeding and atopic diseases should consider this possibility.
Freed, G L; Fraley, J K; Schanler, R J
Fathers participate in choosing the feeding method for their newborns. However they traditionally have not been included in most breast-feeding education programs. To examine expectant fathers' attitudes and knowledge regarding breast-feeding, we surveyed 268 men during the first session of their childbirth education classes at five private hospitals in Houston, Texas. The study population was 81% white, 8% black, and 6% hispanic. Ninety-seven percent (n = 259) of the total were married. Fifty-eight percent (n = 156) reported that their spouses planned to breast-feed exclusively; several significant differences existed between these men and those who reported plans for exclusive formula feeding. The breast-feeding group was more likely to believe breast-feeding is better for the baby (96% vs 62%; P less than .0001), helps with infant bonding (92% vs 53%; P less than .0001), and protects the infant from disease (79% vs 47% P less than .001). The breast-feeding group was also more likely to want their partner to breast-feed (90% vs 13%; P less than .0001) and to have respect for breast-feeding women (57% vs 16%; P less than .0001). Conversely, those in the formula feeding group were more likely to think breast-feeding is bad for breasts (52% vs 22%; P less than .01), makes breasts ugly (44% vs 23%; P less than .05), and interferes with sex (72% vs 24%; P less than .0001). The majority of both groups indicated breast-feeding was not acceptable in public (breast-feeding = 71%, formula feeding = 78%, P less than .05).(ABSTRACT TRUNCATED AT 250 WORDS)
Gokcay, G; Baykal, T; Gokdemir, Y; Demirkol, M
Breast feeding has been recommended for the dietary treatment of infants with organic acidaemias, but studies documenting clinical experience are still very few. Nine infants, diagnosed with methylmalonic acidaemia (n = 4), propionic acidaemia (n = 1), isovaleric acidaemia (n = 2) and glutaric acidaemia type I (n = 2) were breast fed after diagnosis. The age of the patients was 28.9+/- 13.4 months (mean +/- SD) (range 10-57 months). Eight patients were diagnosed with clinical symptoms and one because of an affected sibling. After the control of acute metabolic problems, an initial period with a measured volume of expressed breast milk was continued with on-demand breast feeding with the addition of a special essential amino acid mixture and energy supplements. Breast feeding was well tolerated in seven infants with good growth, metabolic control and neurological outcome. The duration of breast feeding was 12.3+/- 7.4 months (mean +/- SD) (range 4-24 months) in these patients. Breast feeding was terminated in the patient with propionic acidaemia because of two acute metabolic episodes requiring hospitalization, and could not be continued in one of the patients with isovaleric acidaemia owing to shortage of breast milk. A decrease in the frequency of infections, acute metabolic episodes and hospital admissions was observed in breast-fed infants. Breast feeding of infants with organic acidaemias is feasible with close monitoring of clinical parameters such as growth, development and biochemistry, including amino acids, organic acids and ammonia.
John-Stewart, Grace; Mbori-Ngacha, Dorothy; Ekpini, Rene; Janoff, Edward N; Nkengasong, John; Read, Jennifer S; Van de Perre, Phillippe; Newell, Marie-Louise
Breast-feeding substantially increases the risk of HIV-1 transmission from mother to child, and although peripartum antiretroviral therapy prophylaxis significantly decreases the risk of mother-to-child transmission around the time of delivery, this approach does not affect breast-feeding transmission. Increased maternal RNA viral load in plasma and breast milk is strongly associated with increased risk of transmission through breast-feeding, as is breast health, and it has been suggested that exclusive breast-feeding could be associated with lower rates of breast-feeding transmission than mixed feeding of both breast- and other milk or feeds. Transmission through breast-feeding can take place at any point during lactation, and the cumulative probability of acquisition of infection increases with duration of breast-feeding. HIV-1 has been detected in breast milk in cell-free and cellular compartments; infant gut mucosal surfaces are the most likely site at which transmission occurs. Innate and acquired immune factors may act most effectively in combination to prevent primary HIV-1 infection by breast milk.
John-Stewart, Grace; Mbori-Ngacha, Dorothy; Ekpini, Rene; Janoff, Edward N.; Nkengasong, John; Read, Jennifer S.; Van de Perre, Phillippe; Newell, Marie-Louise
Breast-feeding substantially increases the risk of HIV-1 transmission from mother to child, and although peripartum antiretroviral therapy prophylaxis significantly decreases the risk of mother-to-child transmission around the time of delivery, this approach does not affect breast-feeding transmission. Increased maternal RNA viral load in plasma and breast milk is strongly associated with increased risk of transmission through breast-feeding, as is breast health, and it has been suggested that exclusive breast-feeding could be associated with lower rates of breast-feeding transmission than mixed feeding of both breast- and other milk or feeds. Transmission through breast-feeding can take place at any point during lactation, and the cumulative probability of acquisition of infection increases with duration of breast-feeding. HIV-1 has been detected in breast milk in cell-free and cellular compartments; infant gut mucosal surfaces are the most likely site at which transmission occurs. Innate and acquired immune factors may act most effectively in combination to prevent primary HIV-1 infection by breast milk. PMID:14722454
Li, Y; Kong, L; Hotta, M; Wongkhomthong, S A; Ushijima, H
The promotion of breast-feeding is one of the essential interventions for reduction of infant mortality and improving infant development worldwide. The aim of the present study was to examine the current status of infant feeding and the influences of suspected family sociodemographic characteristics and social support as well as maternal knowledge, attitudes and behaviours in infant feeding since the Baby-Friendly Hospital Initiative was launched in Thailand. A total of 221 mother-infant pairs were randomly drawn from six health care centers in Bangkok from 20 April to 1 May 1998. Health care staff, using a structured questionnaire, interviewed the mothers in the health care centers. Most sampled mothers believed that breast milk was the best food for their infants and knew that breast milk had many advantages for infants, mothers and families. Ninety-five percent of mothers breast-fed their infants up to 3 months postpartum, but the prevalence of exclusive breast-feeding was relatively low (62.4%). Multiple logistic regression analyses revealed that the following factors independently increased the risk of mixed or formula feeding during the first 3 months of life: (i) mothers with a full-time job; (ii) grandmothers and other people as the main child caretakers; (iii) mothers who did not have an antenatal plan of exclusive breast-feeding; and (iv) newborns' non-exclusive breast-feeding in hospitals after birth. However, the mother being a housewife, mother as the main child caretaker, an antenatal plan of exclusive breast-feeding and exclusive breast-feeding in hospital were more likely to improve exclusive breast-feeding. The prevalence of exclusive breast-feeding was relatively low. Antenatal plans for exclusive breast-feeding and newborn feeding type in hospital after birth may play key roles in the duration of exclusive breast-feeding. These findings suggest the importance of strengthening implementation of the Baby-Friendly Hospital policy and prenatal health
Koubaa, Afifa Abdelkafi; Abed, Najet Bel; Cheikhrouhou, Héla; Dahmen, Hayet; Askri, Moncef; Ouerfelli, Nabil; Hasni, Khadija
To evaluate the frequency of obesity in children scolarised in Zaghouan, and to show the protective effect of breast feeding. A retrospective study, included 162 children (aged 2 to 6 years), from 3 kindergartens situated in Zaghouan, during 2006. A questionnaire was drawn up, filled out by parents, concerning the breast feeding, the duration, the family antecedents of obesity, and the nutritional practices. Obesity is defined by an Body Mass Index (BMI) > or =97 centile referring to curve of the centiles of BMI for the age (Rolland Cachera). 86% of children were breast fed. 85 children (52%) were nursed by breast exclusively 6 months or over (A group). 54 (34%) are exclusively breast-fed lower than 6 months (B group). 23 (14%) were never breast fed (group C). An overweight was found in 20 children (12%). This overweight is noted respectively in 8%, 9% and 8/23 in the groups A, B and C. Our results showed that there is a statistically significant relation between the BMI and the breast feeding (P < 10 -8). Breast feeding has probably a protective effect against obesity of the child (Odds Ratio = 0.17). Promotion of the breast-feeding and information on its methods and its control are a public health priority, it protects the child and his mother from certain diseases and prevents from childhood obesity. OMS recommends an exclusive breast feeding until the 6 months age, and to continue if possible until the 2 years.
Passos, M C; Lamounier, J A; da Silva, C A; de Freitas, S N; Baudson, M de F
To identify the frequency and median duration of breast-feeding in children aged 0-24 months in the city of Ouro Preto, Brazil. A cross-sectional study was carried out to identify the median duration of breastfeeding in children aged 0-24 months. A sample of 229 children from 1800 households was drawn by clusters at three different occasions and stratified according to the area (urban or rural). The frequency and median duration of breast-feeding were calculated using the life table technique. A median duration of 198 days was found for breast-feeding as a whole: 71 days for the group of exclusive plus mainly breastfeeding and 17 days for exclusive breastfeeding. The current pattern of breast-feeding is of a short-term practice. This evidence suggests the need for intervention programs to promote breast-feeding for longer periods and delay the introduction of food supplementation, preventing the early weaning.
Although breast milk provides the best nutrition for the infant, breast-feeding has been decreasing with the growth in use of prepared milk formulas. This paper evaluates the available biblical literature dealing with breast-feeding. The research is unique in character, as it combines contemporary medical knowledge with presentation of cases taken from ancient history. We include no commentaries, but refer only to the words of the Bible exactly as written. Biblical texts relating to breast-feeding were examined and the cases of biblical characters who were breast-fed were studied. The great historical figures such as Isaac, Rebecca, Moses, Samuel, and Joash were breast-fed, openly or secretly. If the biological mother was unable to nurse her child, a wet nurse took over the feeding. Breast-feeding was the only way infants could survive at that time. Weaning day was very important and was celebrated. The wet nurse played an important role in family life, in some cases remaining to live with the infant after weaning, through childhood and even into adulthood. In spite of advanced technology that provides artificial infant formulas, contemporary mothers, just like biblical mothers, should be encouraged to breast-feed their infants.
Mattsson, Elisabet; Funkquist, Eva-Lotta; Wickström, Maria; Nyqvist, Kerstin H; Volgsten, Helena
to compare the influence of supplementary artificial milk feeds on breast feeding and certain clinical parameters among healthy late preterm infants given regular supplementary artificial milk feeds versus being exclusively breast fed from birth. a comparative study using quantitative methods. Data were collected via a parental diary and medical records. parents of 77 late preterm infants (34 5/7-36 6/7 weeks), whose mothers intended to breast feed, completed a diary during the infants׳ hospital stay. infants who received regular supplementary artificial milk feeds experienced a longer delay before initiation of breast feeding, were breast fed less frequently and had longer hospital stays than infants exclusively breast fed from birth. Exclusively breast-fed infants had a greater weight loss than infants with regular artificial milk supplementation. A majority of the mothers (65%) with an infant prescribed artificial milk never expressed their milk and among the mothers who used a breast-pump, milk expression commenced late (10-84 hours after birth). At discharge, all infants were breast fed to some extent, 43% were exclusively breast fed. clinical practice and routines influence the initiation of breast feeding among late preterm infants and may act as barriers to the mothers׳ establishment of exclusive breast feeding. Copyright © 2015 Elsevier Ltd. All rights reserved.
As more mothers elect to breast-feed, more concomitant problems in mothers and babies are reported that are thought to contraindicate breast-feeding. Many frequently cited maternal and infant reasons for stopping breast-feeding are not valid. Breast-feeding can usually be maintained if the physician remembers that breast-feeding is important for the baby and mother and not simply another feeding method. ImagesFigure 1 PMID:21229077
Flores, Angela; Anchondo, Inés; Huang, Cindy; Villanos, MariaTeresa; Finch, Casey
To determine why mothers in El Paso, Texas, choose to breast-feed but not exclusively and why breast-feeding duration is short. This was a cross-sectional observational study of 300, mostly Mexican American, low-income mothers delivering at a county hospital who answered questions about breast-feeding and formula feeding, sociodemographics, and health habits. Most mothers (92.6%) in our study initiated breast-feeding, but only 20.3% breast-fed exclusively at the time of hospital discharge. Most mothers (73%) self-identified as Mexicans or Mexican Americans living on the border of the United States and Mexico. Mothers in our study chose to breast-feed if they decided to breast-feed during pregnancy, had breast-fed a previous child, had support from a female relative, and had attended college. Distinctively, most mothers in our study chose "las dos cosas" or to breast-feed and formula feed together early after birth. Acculturation failed to explain the breast-feeding decisions. Mexican American mothers who decided to breast-feed during pregnancy, breast-fed another child, attended college, and enlist a female relative's breast-feeding help were more likely to choose breast-feeding exclusively. Most Mexican American low-income mothers in our study chose "las dos cosas."
Monteiro, J C S; Dias, F A; Stefanello, J; Reis, M C G; Nakano, A M S; Gomes-Sponholz, F A
to characterise breast feeding practices among Brazilian adolescents and identify their breast feeding needs. the study was undertaken in Ribeirão Preto, Brazil in two stages. The first stage analysed data from the Second National Survey of Breast-feeding Prevalence, held in August 2008, which included 229 adolescent mothers. The second stage was a qualitative approach, and involved interviews with 10 adolescent mothers in a primary care unit. The data from the first stage were analysed in June 2010 based on descriptive statistics. The data obtained from the interviews were transcribed and organised using thematic content analysis. breast feeding was reported by 75% of the adolescent mothers. Of the 144 mothers with infants aged <180 days, 84% reported that they were breast feeding: 19% were breast feeding exclusively, 17% were breast feeding predominantly, 49% were providing complementary feeding, and 16% had weaned their infants. Analysis of the interviews led to the identification of three thematic units: concern for the child's health; breast feeding difficulties; and health team and family support. the majority of the adolescent mothers presented conditions that were favourable to breast feeding (e.g. did not work outside the home, only had one child, breast fed in the first hour post partum). However, the practice of breast feeding still failed to meet the recommendations of the World Health Organization. The interviews led to identification of the breast feeding needs and demands of adolescent mothers, many of which were related to the needs of their infants. It is important to know what adolescent mothers think about breast feeding, in order to encourage the establishment of practices to keep breastfeeding as longer as possible in a satisfactory way for both mothers and infants. Copyright © 2013 Elsevier Ltd. All rights reserved.
Brzozowski, D; Niessen, M; Evans, H B; Hurst, L N
The breast-feeding practices of a series of postpartum women, who had undergone prior reduction mammaplasty by means of an inferior pedicle approach, are reported in this retrospective study. Also identified are the factors that influenced the decision to breast-feed postoperatively. From a patient pool of 544 individuals who elected to have reduction mammaplasty between 1984 and 1994 (age range, 15 to 35 years), 334 could be contacted and interviewed by means of telephone by using a standardized questionnaire. Successful breast-feeding was defined as the ability to feed for a duration equal to or greater than 2 weeks. Seventy-eight patients had children after their breast reduction surgery. Fifteen of the 78 patients (19.2 percent) breast-fed exclusively, 8 (10.3 percent) breast-fed with formula supplementation, 14 (17.9 percent) had an unsuccessful breast-feeding attempt, and 41 (52.6 percent) did not attempt breast-feeding. Of the 41 patients not attempting to breast-feed, 9 patients did so as a direct consequence of discouragement by a health care professional. Further reasons for feeding with supplementation, having an unsuccessful attempt, and not attempting to breast-feed are presented. Of the 78 women who had children postoperatively, a total of 27 were discouraged from breast-feeding by medical professionals with only 8 of the 27 (29.6 percent) subsequently attempting, despite this recommendation. In comparison, 26 patients were encouraged to breast-feed; nineteen (73.1 percent) of them did subsequently attempt breast-feeding. This rate is statistically significant by using a chi2 test with 1 df(p = 0.0016). Postpartum breast engorgement and lactation was experienced by 31 of the 41 patients not attempting to breast-feed. Of these 31 patients, 19 believed that they would have been able to breast-feed due to the extent of breast engorgement and lactation experienced. Given the use of an inferior flap mammaplasty technique and patient encouragement, the
Ouyang, Yan-Qiong; Su, Min; Redding, Sharon R
exclusive breast feeding in China is relatively low and no research has been conducted to explore the difficulties and desires of Chinese lactating mothers. Currently, Chinese women turn to massage therapists to increase breastmilk volume, implying that many breast-feeding women faced problems but had few support mechanisms.This study aimed to explore the difficulties and desires of Chinese breast-feeding women and to propose strategies for increasing the rate of exclusive breast feeding. three hundred and seventy-five primiparous women were recruited from two randomized cluster communities in Wuhan following ethical approval. Face-to-face semistructured interviews were conducted with 76 of the participants to collect data on their infants' feeding status, duration of exclusive breast feeding, reasons for stopping, difficulties encountered, and sources of support for lactation. the breast feeding initiation rate was 93.6%, but exclusive breast feeding was only 6.2% at six months. The most frequently cited reason for giving up exclusive breast feeding was perceived breastmilk insufficiency. Women cited a desire for professional and individualised instruction from following resources: (1) lactation consultants in hospital and communities; (2) Qualified cuirushi; (3) breast feeding website;(4) Relatives, friends and peers;(5) Telephone hotline. to improve the rate and duration of exclusive breast feeding in China, effective and available resources must be available. Timely,professional and face-to-face lactation counselling such as lactation consultant, qualified cuirushin is needed. Copyright © 2016 Elsevier Ltd. All rights reserved.
Limeira, Adriana Bezerra; Aguiar, Carlos Menezes; de Lima Bezerra, Niedje Siqueira; Câmara, Andréea Cruz
The purpose of this study was to evaluate the association between breast-feeding duration and the subsequent occurrence of posterior crossbite in Brazilian children. A cross-sectional study was conducted involving 714 six- to nine-year-old children. A questionnaire was completed by mothers or guardians of the children concerning the length of time they were exclusively breast-fed and the breast-feeding duration. A clinical examination of each child was conducted to detect posterior crossbite. Data were analyzed using Pearson's chi-square test at a five percent significance level. There was a posterior crossbite prevalence of approximately 15 percent. There was no statistically significant association between posterior crossbite and age or gender ( P >.05). The prevalence of posterior crossbite was higher among children who were not breast-fed (28 percent) than among breast-fed children (13 percent). There was a significant association between posterior crossbite and the length of time that children were exclusively breast-fed and the breast-feeding duration ( P <.05 percent). The prevalence of posterior crossbite gradually decreased as exclusive breast-feeding duration increased, and there was a relationship between breast-feeding duration and the occurrence of posterior crossbite.
Constantinescu, Serban; Pai, Akshta; Coscia, Lisa A; Davison, John M; Moritz, Michael J; Armenti, Vincent T
Transplantation affords recipients the potential for a full life and, for some, parenthood. Female transplant recipients must continue to take immunosuppression during pregnancy and breast-feeding. This article reviews case and series reports regarding breast-feeding in those taking transplant medications. Avoidance of breast-feeding has been the customary advice because of the potential adverse effects of immunosuppressive exposure on the infant. Subsequent studies have demonstrated that not all medication exposure translates to risk for the infant, that the exposure in utero is greater than via breast milk and that no lingering effects due to breast-feeding have been found to date in infants who were breast-fed while their mothers were taking prednisone, azathioprine, cyclosporine, and/or tacrolimus. Thus, except for those medications where clinical information is inadequate (mycophenolic acid products, sirolimus, everolimus, and belatacept), the recommendation for transplant recipients regarding breast-feeding has evolved into one that is cautiously optimistic. Copyright © 2014 Elsevier Ltd. All rights reserved.
de la Torre, M J; Martín-Calama, J; Hernandez-Aguilar, M T
Human milk is the best way to nurture the human infant. By breast-feeding their babies, mothers provide them with the best opportunities to wholly develop their potential, while protecting the infants and themselves from a whole range of diseases in the near future and in the years to come. Even though these benefits are widely known and there is ample scientific evidence on the topic, it seems from published data that Spanish women are not breast-feeding their babies as much and for as long as they should. Less than 90% start breast-feeding, at 1 month there is already an attrition of 30%, at 3 months more than half of the infants are taking artificial milk and by 6 months only 10% continue to breast-feed their infants. Low birth weight, Caesarean section and low study level are among the more significant factors that negatively affect breast-feeding. There is still work to do to improve this situation. Promotion of breast-feeding among the general population, mothers and health professionals is needed.
Di Labio, Luisa; Pane, Concettina; Cicolini, Giancarlo
The factors associated with exclusive breast-feeding in a Naples health district were studied in October 2008 in the period between the first and second vaccinations (neonates aged between 60 and 120 days) . Questions regarded both the mother and the child and the answers were collected in a database and compared with other methods of nutrition or mixed methods. Statistical analysis was performed using multivariate logistic regression. Results showed that only 38.5% of the mothers interviewed practiced breast-feeding alone while 20% did mixed feeding and 41.5% preferred artificial feeding. The variables negatively related to breast-feeding were: breast problems, older-aged mothers, Cesarean section, first experience of breast-feeding, lack of rooming-in and/or prenatal preparative courses. Positively associated variables were: higher level of education of the mother, higher level of information regarding the advantages of breast-feeding. The conclusions of this study confirm those of previous studies regarding the relationship between exclusive breast-feeding and biological and social factors.
Even though women have known for centuries that breast feeding has a contraceptive effect, family planning agents have only recently promoted it. Family planning specialists at a meeting in Bellagio, Italy, on breast feeding developed directives referred to as the Lactational Amenorrhea Method (LAM). Adherence to these directives assure effective protection against pregnancy until resumption of menstruation, expansion of infant feeding to foods other than breast milk, or until 6 months postpartum. Nipple stimulation during suckling is sufficient to suppress ovulation. Frequent suckling or more intense suckling maintains the contraceptive effect, so the directives insist that mothers exclusively or almost exclusively breast feed their infants. LAM provides 98% effective protection against pregnancy for 6 months if women observe it as directed. After 6 months, they should use another family planning method. Scientists are trying to see whether they can make the directives more simple. They will discuss this possibility at their next international meeting in 1993 or 1994. Research indicates that the most crucial rule is amenorrhea and use of this rule will make LAM more easy to learn and use, thereby increasing its use. It is difficult to motivate hospital and family planning clinic staff to promote LAM. Information and education are needed to support LAM. for example, a project in Honduras is using peer counseling to promote LAM. Family Health International is following 1000 women for 1 year postpartum in Pakistan and the Philippines. This study's 6-month LAM efficacy rate was around 95%. Little research has looked at the cost effectiveness of LAM. Optimally, LAM is a temporary contraceptive method which must be followed immediately by another contraceptive method. Indeed, LAM counseling should often pregnancy. LAM supporters do not intend for LAM to be a substitute for family planning, but want LAM to be another method in the contraceptive method mix.
Betrán, Ana P; de Onís, Mercedes; Lauer, Jeremy A; Villar, José
Objective To estimate the effect of exclusive breast feeding and partial breast feeding on infant mortality from diarrhoeal disease and acute respiratory infections in Latin America. Design Attributable fraction analysis of national data on infant mortality and breast feeding. Setting Latin America and the Caribbean. Main outcome measures Mortality from diarrhoeal disease and acute respiratory infections and nationally representative breastfeeding rates. Results 55% of infant deaths from diarrhoeal disease and acute respiratory infections in Latin America are preventable by exclusive breast feeding among infants aged 0-3 months and partial breast feeding throughout the remainder of infancy. Among infants aged 0-3 months, 66% of deaths from these causes are preventable by exclusive breast feeding; among infants aged 4-11 months, 32% of such deaths are preventable by partial breast feeding. 13.9% of infant deaths from all causes are preventable by these breastfeeding patterns. The annual number of preventable deaths is about 52 000 for the region. Conclusions Exclusive breast feeding of infants aged 0-3 months and partial breast feeding throughout the remainder of infancy could substantially reduce infant mortality in Latin America. Interventions to promote breast feeding should target younger infants. What is already known on this topicInfant mortality is lower among breast fed than non-breast fed infantsThe reductions are greatest for deaths from diarrhoeal disease and acute respiratory infectionsWhat this study addsExclusive breast feeding of infants aged 0-3 months and partial breast feeding for the remainder of the first year would prevent about 52 000 infant deaths a year in Latin AmericaThis corresponds to 13.9% of infant deaths from all causesPromotion of breast feeding has an important role in increasing survival of infants PMID:11498485
Holmes, Alison Volpe; Auinger, Peggy; Howard, Cindy R
To examine combination breast milk and formula-feeding (CBFF), defined as daily breast-feeding and formula-feeding begun in the first week of life and to examine associations between CBFF and overall breast-feeding duration. We used the National Health and Nutrition Examination Survey, 1999-2006, to determine the prevalence of CBFF in both univariable and multivariable analyses. We examined breast-feeding duration using Kaplan-Meier and Cox proportional hazards analyses. Among 6788 children ages 0-71 months, 8% were CBFF and 55% were exclusively breast-fed during the first week of life. Factors independently associated with CBFF were Hispanic ethnicity (adjusted OR, 3.81) and black race (adjusted OR, 2.59). CBFF was associated with decreased overall breast-feeding duration in the full cohort (P < .001) but not in the Hispanic or black subgroups. CBFF and formula-feeding, when compared with 4 months of exclusive breast-feeding, were associated with an increased risk for overweight/obesity between ages 2 and 6 years. In a nationally representative sample, CBFF is associated with shorter overall breast-feeding duration in white but not Hispanic or black mother-baby dyads. A significant number of US infants, though breast-fed, do not receive the health benefits of exclusive breast-feeding. Copyright © 2011 Mosby, Inc. All rights reserved.
Hazir, Tabish; Akram, Dure-Samin; Nisar, Yasir Bin; Kazmi, Narjis; Agho, Kingsley E; Abbasi, Saleem; Khan, Amira M; Dibley, Michael J
Exclusive breast-feeding is estimated to reduce infant mortality in low-income countries by up to 13 %. The aim of the present study was to determine the risk factors associated with suboptimal breast-feeding practices in Pakistan. A cross-sectional study using data extracted from the multistage cluster sample survey of the Pakistan Demographic and Health Survey 2006-2007. A nationally representative sample of households. Last-born alive children aged 0-23 months (total weighted sample size 3103). The prevalences of timely initiation of breast-feeding, bottle-feeding in children aged 0-23 months, exclusive breast-feeding and predominant breast-feeding in infants aged 0-5 months were 27·3 %, 32·1 %, 37·1 % and 18·7 %, respectively. Multivariate analysis indicated that working mothers (OR = 1·48, 95 % CI 1·16, 1·87; P = 0·001) and mothers who delivered by Caesarean section (OR = 1·95, 95 % CI 1·30, 2·90; P = 0·001) had significantly higher odds for no timely initiation of breast-feeding. Mothers from North West Frontier Province were significantly less likely (OR = 0·37, 95 % CI 0·23, 0·59; P < 0·001) not to breast-feed their babies exclusively. Mothers delivered by traditional birth attendants had significantly higher odds to predominantly breast-feed their babies (OR = 1·96, 95 % CI 1·18, 3·24; P = 0·009). The odds of being bottle-fed was significantly higher in infants whose mothers had four or more antenatal clinic visits (OR = 1·93, 95 % CI 1·46, 2·55; P < 0·001) and belonged to the richest wealth quintile (OR = 2·41, 95 % CI 1·62, 3·58; P < 0·001). The majority of Pakistani mothers have suboptimal breast-feeding practices. To gain the full benefits of breast-feeding for child health and nutrition, there is an urgent need to develop interventions to improve the rates of exclusive breast-feeding.
Rollins, Nigel; Meda, Nicolas; Becquet, Renaud; Coutsoudis, Anna; Humphrey, Jean; Jeffrey, Barbara; Kanshana, Siripon; Kuhn, Louise; Leroy, Valeriane; Mbori-Ngacha, Dorothy; McIntyre, James; Newell, Marie-Louise
Approaches to reducing or preventing the risk of postnatal transmission through breast-feeding include the avoidance of all breast-feeding and the use of exclusive replacement feeds or exclusive breast-feeding for a limited duration with early and rapid cessation of breast-feeding around 4-6 months of age. The efficacy and safety of the latter approach have not been established and studies are in progress to provide further information. In addition, inactivation of HIV in breast milk would allow breast-feeding to continue while reducing the risk of postnatal transmission of HIV and may be usefully applied in certain circumstances, such as for premature infants or while a mother recovers from mastitis. In this review, experience is reported from clinical trials or studies additional to their main objective of assessing rates and risk factors for mother-to-child transmission. This may inform policy, programming, and training options and may be especially valuable in the absence of conclusive data on the efficacy of the interventions to be applied during the breast-feeding period.
Agostoni, Carlo; Braegger, Christian; Decsi, Tamas; Kolacek, Sanja; Koletzko, Berthold; Michaelsen, Kim Fleischer; Mihatsch, Walter; Moreno, Luis A; Puntis, John; Shamir, Raanan; Szajewska, Hania; Turck, Dominique; van Goudoever, Johannes
This medical position article by the European Society for Paediatric Gastroenterology, Hepatology, and Nutrition summarises the current status of breast-feeding practice, the present knowledge on the composition of human milk, advisable duration of exclusive and partial breast-feeding, growth of the breast-fed infant, health benefits associated with breast-feeding, nutritional supplementation for breast-fed infants, and contraindications to breast-feeding. This article emphasises the important role of paediatricians in the implementation of health policies devised to promote breast-feeding.The European Society for Paediatric Gastroenterology, Hepatology, and Nutrition Committee on Nutrition recognises breast-feeding as the natural and advisable way of supporting the healthy growth and development of young children. This article delineates the health benefits of breast-feeding, reduced risk of infectious diarrhoea and acute otitis media being the best documented. Exclusive breast-feeding for around 6 months is a desirable goal, but partial breast-feeding as well as breast-feeding for shorter periods of time are also valuable. Continuation of breast-feeding after the introduction of complementary feeding is encouraged as long as mutually desired by mother and child.The role of health care workers, including paediatricians, is to protect, promote, and support breast-feeding. Health care workers should be trained in breast-feeding issues and counselling, and they should encourage practices that do not undermine breast-feeding. Societal standards and legal regulations that facilitate breast-feeding should be promoted, such as providing maternity leave for at least 6 months and protecting working mothers.
Vijayalakshmi, Poreddi; Susheela, T; Mythili, D
Background Breast feeding has several benefits for both the infants and mothers. However, despite strong evidences in support of breast feeding its prevalence has remained low worldwide. The objective of the present study was to examine the knowledge and attitude towards breast feeding and infant feeding practices among Indian postnatal mothers. Methodology A cross sectional descriptive study was carried out among randomly selected postnatal mothers at Pediatric outpatient department at a tertiary care center. Data was collected through face-to-face interview using a structured questionnaire. Results Our findings revealed that a majority (88.5%) of the mothers were breast feeders. However, merely 27% of the mothers were exclusive breast feeders and only 36.9% initiated breast feeding within an hour. While mothers have good knowledge on breast feeding (12.05±1.74, M±SD), the average score of the Iowa Infant Feeding Scale (IIFAS) (58.77±4.74, M ±SD) indicate neutral attitudes toward breast feeding. Mothers those who were currently breast feeding (58.83 ± 4.74) had more positive attitudes than non- breastfeed mothers (45.21±5.22). Conclusion Our findings also show that the level of exclusive breast-feeding was low. Thus, it is important to provide prenatal education to mothers and fathers on breast-feeding. We also recommend strengthening the public health education campaigns to promote breast-feeding. PMID:26715916
Vijayalakshmi, Poreddi; Susheela, T; Mythili, D
Breast feeding has several benefits for both the infants and mothers. However, despite strong evidences in support of breast feeding its prevalence has remained low worldwide. The objective of the present study was to examine the knowledge and attitude towards breast feeding and infant feeding practices among Indian postnatal mothers. A cross sectional descriptive study was carried out among randomly selected postnatal mothers at Pediatric outpatient department at a tertiary care center. Data was collected through face-to-face interview using a structured questionnaire. Our findings revealed that a majority (88.5%) of the mothers were breast feeders. However, merely 27% of the mothers were exclusive breast feeders and only 36.9% initiated breast feeding within an hour. While mothers have good knowledge on breast feeding (12.05±1.74, M±SD), the average score of the Iowa Infant Feeding Scale (IIFAS) (58.77±4.74, M ±SD) indicate neutral attitudes toward breast feeding. Mothers those who were currently breast feeding (58.83 ± 4.74) had more positive attitudes than non- breastfeed mothers (45.21±5.22). Our findings also show that the level of exclusive breast-feeding was low. Thus, it is important to provide prenatal education to mothers and fathers on breast-feeding. We also recommend strengthening the public health education campaigns to promote breast-feeding.
Bai, Dorothy Li; Fong, Daniel Yee Tak; Lok, Kris Yuet Wan; Wong, Janet Yuen Ha; Tarrant, Marie
To investigate the prevalence and predictors of expressed breast-milk feeding in healthy full-term infants and its association with total duration of breast-milk feeding. Prospective cohort study. In-patient postnatal units of four public hospitals in Hong Kong. A total of 2450 mother-infant pairs were recruited in 2006-2007 and 2011-2012 and followed up prospectively for 12 months or until breast-milk feeding had stopped. Across the first 6 months postpartum, the rate of exclusive expressed breast-milk feeding ranged from 5·1 to 8·0 % in 2006-2007 and from 18·0 to 19·8 % in 2011-2012. Factors associated with higher rate of exclusive expressed breast-milk feeding included supplementation with infant formula, lack of previous breast-milk feeding experience, having a planned caesarean section delivery and returning to work postpartum. Exclusive expressed breast-milk feeding was associated with an increased risk of early breast-milk feeding cessation when compared with direct feeding at the breast. The hazard ratio (95 % CI) ranged from 1·25 (1·04, 1·51) to 1·91 (1·34, 2·73) across the first 6 months. Mothers of healthy term infants should be encouraged and supported to feed directly at the breast. Exclusive expressed breast-milk feeding should be recommended only when medically necessary and not as a substitute for feeding directly at the breast. Further research is required to explore mothers' reasons for exclusive expressed breast-milk feeding and to identify the health outcomes associated with this practice.
Cruz-Korchin, Norma; Korchin, Leo
A retrospective study was performed in which the breast-feeding success of women of childbearing age (15 to 40 years) with macromastia but no prior breast surgery was compared with that of women of similar age who had undergone medial pedicle/vertical pattern reduction mammaplasty. All women completed a self-administered questionnaire that provided information on their breast-feeding success. The control group consisted of 149 women with macromastia (mean age, 27 years) who had been evaluated for possible breast reduction surgery and who had children before their consultation. The study group consisted of 58 women (mean age, 29 years) who had children after their vertical mammaplasty. The mean weight of breast tissue removed was 610 g per breast. None of the patients had absent nipple sensation. A period of 2 weeks or more was chosen as the defining duration of a successful breast-feeding attempt. Those individuals judged able to breast-feed were further classified on the basis of having breast-fed exclusively or with supplementation. The results demonstrated that, of the women who attempted to breast-feed, 61 percent in the control group and 65 percent in the study group were successful, with no significant difference between the groups (p > 0.05). The breakdown of the successful groups indicated that 36 percent in the control group and 38 percent in the study group supplemented their breast-feeding with formula. The groups were not significantly different (p > 0.05). In conclusion, this study found no significant difference in the rate of breast-feeding success between women who had medial pedicle/vertical pattern reduction mammaplasty and women who had no prior breast surgery.
Stewart-Knox, B; Gardiner, K; Wright, M
Breast-feeding rates are low in Northern Ireland (NI) compared with other regions of Europe. The aim of this study has therefore been to define and explore factors determining infant feeding decisions with a view to the planning of future research and intervention needs. Participants were approached at convenience from the throughput of women attending a large teaching hospital antenatal clinic to take part in focus group discussion. Dominant themes indicated that the main barriers to breast-feeding are restricted freedom and independence associated with family issues, return to work, societal embarrassment and perceived social isolation. The dialogue suggested that breast-feeding leads to inability to carry out everyday activities and social exclusion. Incompatible social norms make it difficult for mothers to breast-feed successfully. This implies that future promotional efforts should take a societal approach.
MENNELLA, JULIE A.; BEAUCHAMP, GARY K.
Beer consumption by nursing women altered the sensory qualities of their milk and the behavior of their infants during breast-feeding in the short term. The infants consumed significantly less milk during the 4-hr testing sessions in which their mothers drank alcoholic beer compared to when the mothers drank nonalcoholic beer; this decrease in milk intake was not due to a decrease in the number of times the babies fed. Although the infants consumed less of the alcohol-flavored milk, the mothers believed their infants had ingested enough milk, reported that they experienced a letdown during nursing, and felt they had milk remaining in their breasts at the end of the majority of feedings. Moreover, the mothers terminated the feeds the same percentage of time on both testing days. The mechanism by which the consumption of alcoholic beer by lactating women decreases milk intake by their nurslings remains to be determined. PMID:8293892
Mennella, J A; Beauchamp, G K
Beer consumption by nursing women altered the sensory qualities of their milk and the behavior of their infants during breast-feeding in the short term. The infants consumed significantly less milk during the 4-hr testing sessions in which their mothers drank alcoholic beer compared to when the mothers drank nonalcoholic beer; this decrease in milk intake was not due to a decrease in the number of times the babies fed. Although the infants consumed less of the alcohol-flavored milk, the mothers believed their infants had ingested enough milk, reported that they experienced a letdown during nursing, and felt they had milk remaining in their breasts at the end of the majority of feedings. Moreover, the mothers terminated the feeds the same percentage of time on both testing days. The mechanism by which the consumption of alcoholic beer by lactating women decreases milk intake by their nurslings remains to be determined.
Yimyam, Susanha; Hanpa, Wasana
Resuming work is often considered an obstacle for continued breast feeding. The objectives of this participatory action research study were to develop a breast feeding support model in the workplace and to compare breast feeding rates before and after implementation of the breast feeding support campaign. Twenty-four women participated before the implementation of the breast feeding support campaign, whereas 31 women participated after the campaign. Data were collected by interviewing employed women about their breast feeding practices within six months post partum. Additional data were collected through interviews with the workplace administrator and head of work sections as well as observation of the breast feeding support campaigns. Qualitative data were analysed using thematic analysis, whereas quantitative data were analysed using descriptive statistics and χ(2) test. The workplace breast feeding support model was developed based on the concept of Mother-Friendly Workplace Initiatives by the World Alliance for Breastfeeding Action (WABA) and the Thai government׳s promotion of a workplace breast feeding corner. Within this model, a committee for breast feeding support was created for working with the research team to develop breast feeding activities and media for breast feeding education and breast feeding support campaigns in the workplace. Breast feeding rates at six months after implementation of the breast feeding support campaign were significantly higher than rates before, both for exclusive breast feeding and any breast feeding at levels .004 and .033, respectively. These results suggest that breast feeding should be encouraged in every workplace depending on context. Individual advice and help for employed mothers should be provided from pregnancy through weaning in the postpartum period. Copyright © 2014 Elsevier Ltd. All rights reserved.
Mezzacappa, E S; Kelsey, R M; Myers, M M; Katkin, E S
Two studies examined the effects of breast-feeding on maternal cardiovascular function. In the first experiment, groups of breast-feeding and bottle-feeding women were compared on preejection period (PEP), heart rate (HR), cardiac output (CO), and total peripheral resistance (TPR) recorded for 1-min periods before and during standard laboratory stressors. Compared with bottle-feeders, breast-feeders had higher CO throughout the session, and greater decreases in CO and increases in TPR during cold pressor. In the second experiment, HR and blood pressure (BP) were compared before and after one breast-feeding and one bottle-feeding session in a within-subjects design. Both feeding methods increased BP but decreased HR, and systolic BP was higher for the breast-feeding than the bottle-feeding condition. Both studies support the notion that breast-feeding alters maternal cardiovascular function, possibly through the actions of oxytocin.
Tan, K L
A certain attitude and lifestyle is needed if breast feeding is to be successful. It must have priority over all other activities save the very basic ones. The rural environment provides a situation in which breast feeding can flourish . With urbanisation and the accompanying change in lifestyle breast feeding becomes very difficult. Since successful breast feeding needs strong motivation, the change in attitude of urbanised wives makes it even more unlikely. The Singapore experience demonstrates this convincingly; even though awareness of the benefits of breast feeding is widespread, the motivation to breast feed is not. Remedial measures should take into consideration the need to motivate the mother and family, the prevention of commercial infant food companies influencing public opinion, and incentives for the working mothers to breast feed.
Eliassen, A Heather; Tamimi, Rulla M; Spiegelman, Donna; Michels, Karin B; Missmer, Stacey A
Objective To investigate the association between lifetime breast feeding, exclusive breast feeding, postpartum amenorrhea, and incidence of endometriosis among parous women. Design Prospective cohort study. Setting Nurses’ Health Study II, 1989-2011. Participants 72 394women who reported having one or more pregnancies that lasted at least six months, 3296 of whom had laparoscopically confirmed endometriosis. For each pregnancy, women reported duration of total breast feeding, exclusive breast feeding, and postpartum amenorrhea. Main outcome measures Incident self reported laparoscopically confirmed endometriosis (96% concordance with medical record) in parous women. Multivariable Cox proportional hazard models were used to calculate hazard ratios and 95% confidence intervals for diagnosis of endometriosis. Results Duration of total and exclusive breast feeding was significantly associated with decreased risk of endometriosis. Among women who reported a lifetime total length of breast feeding of less than one month, there were 453 endometriosis cases/100 000 person years compared with 184 cases/100 000 person years in women who reported a lifetime total of ≥36 months of breast feeding. For every additional three months of total breast feeding per pregnancy, women experienced an 8% lower risk of endometriosis (hazard ratio 0.92, 95% confidence interval 0.90 to 0.94; P<0.001 for trend) and a 14% lower risk for every additional three months of exclusive breast feeding per pregnancy (0.86, 0.81 to 0.90; P<0.001 for trend). Women who breastfed for ≥36 months in total across their reproductive lifetime had a 40% reduced risk of endometriosis compared with women who never breast fed (0.60, 0.50 to 0.72). The protective association with breast feeding was strongest among women who gave birth within the past five years (P=0.04 for interaction). The association with total breast feeding and exclusive breast feeding on endometriosis was partially influenced
Mullaney, Laura; O'Higgins, Amy C; Cawley, Shona; Kennedy, Rachel; McCartney, Daniel; Turner, Michael J
We examined whether breast-feeding, and in particular exclusive breast-feeding, was associated with maternal weight and body composition changes at 4 months postpartum independently of other maternal variables. Prospective longitudinal study. Women were recruited in the first trimester after an ultrasound examination confirmed an ongoing singleton pregnancy. Weight and body composition were measured using advanced bio-electrical impedance analysis at the first antenatal visit and 4 months postpartum. Detailed questionnaires were completed on breast-feeding, socio-economic status, diet and exercise in addition to routine clinical and sociodemographic details. Large Irish university maternity hospital. Women who delivered a baby weighing ≥500 g between November 2012 and March 2014. At the postpartum visit, the mean weight was 70·9 (sd 14·2) kg (n 470) and the mean BMI was 25·9 (sd 5·0) kg/m2. 'Any breast-feeding' was reported by 65·1 % of women (n 306). Irish nativity (OR=0·085, P<0·001), current smoking (OR=0·385, P=0·01), relative income poverty (OR=0·421, P=0·04) and deprivation (OR=0·458, P=0·02) were negatively associated with exclusive breast-feeding. At 4 months postpartum there was no difference in maternal weight change between women who exclusively breast-fed and those who formula-fed (+2·0 v. +1·1 kg, P=0·13). Women who exclusively breast-fed had a greater increase in percentage body fat at 4 months postpartum compared with women who formula-fed (+1·0 v. -0·03 %, P=0·02), even though their dietary quality was better. Exclusive breast-feeding was not associated with postpartum maternal weight or body fat percentage change after adjusting for other maternal variables. There are many reasons why breast-feeding should be strongly promoted but we found no evidence to support postpartum weight management as an advantage of breast-feeding.
Cleugh, F; Langseth, A
Despite extensive evidence about the benefits of breast feeding for both infants and mothers, breastfeeding rates in the UK remain low. Most infants presenting with feeding issues are otherwise well but are often over diagnosed with clinical conditions such as maternal milk insufficiency, cow's milk intolerance or reflux. With simple advice and troubleshooting common problems, all child health professionals can support mothers to establish and continue breast feeding exclusively for longer. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.
Görbe, E; Kõhalmi, B; Gaál, G; Szánthó, A; Rigó, J; Harmath, A; Csabay, L; Szabó, Gy
To investigate the influence of pacifier use and the introduction of formula milk on breast feeding. The mothers of 356 healthy newborn infants who initiated breast feeding while in-patients were interviewed within 3 days of birth and later at 2 and 6 months postpartum. Information regarding previous birth, breast-feeding frequency, pacifier use and the adoption of formula milk were obtained. The data were analyzed using chi2 and Kruskal-Wallis tests. At the end of the second month, 264 (74%) of the mothers were still breast feeding; by the end of the sixth month this had fallen to 236 (66%). Among the 356 mothers, 152 had at least one previous infant, and 132 (86.8%) of them had breast fed a previous infant. Of the women who breast fed their previous infant for more than 2 months, 112 (84.8%) breast fed the current child until the end of the second month and 104 (78.7%) until the end of the sixth month after delivery. Of all investigated patients, 204 were primiparous (57.3%). Of these, 152 (74.5%) breast fed until the end of the second month, and 132 (64.7%) until the end of the sixth month after delivery. Amongthe 204 primiparae, 92 (45%) gave formula to their newborn infants. Forty-four of these 92 mothers (47.8%) had discontinued breast feeding by the end of the second month. Among the 356 newborn infants, 220 used pacifiers at the end of the second month. Within this group, 72 (33%) of the infants did not breast feed, while 148 (67%) did breast feed. Of all investigated mothers, 136 did not give pacifiers to their infants and only eight of these mothers (6%) had stopped breast feeding at the end of the second month. We found an inverse correlation between pacifier usage and breast feeding. Breast feeding was most common among multiparous mothers.
Haider, R.; Islam, A.; Hamadani, J.; Amin, N. J.; Kabir, I.; Malek, M. A.; Mahalanabis, D.; Habte, D.
Lactation counsellors were trained to advise mothers of partially breast-fed infants who were admitted to hospital because of diarrhoea, so that they could start exclusive breast-feeding during their hospital stay. Infants (n = 250) up to 12 weeks of age were randomized to intervention and control groups. Mothers in the intervention group were individually advised by the counsellors while mothers in the control group received only routine group health education. During follow-up at home by the counsellors a week later, only the mothers in the intervention group were counselled. All the mothers were evaluated for infant feeding practices at home two weeks after discharge. Among the 125 mother-infant pairs in each group, 60% of mothers in the intervention group were breast-feeding exclusively at discharge compared with only 6% in the control group (P < 0.001); two weeks later, these rates rose to 75% and 8% in the intervention and control groups, respectively (P < 0.001). However, 49% of mothers in the control group reverted back to bottle-feeding compared with 12% in the intervention group (P < 0.001). Thus, individual counselling had a positive impact on mothers to start exclusive breast-feeding during hospitalization and to continue the practice at home. Maternal and child health facilities should include lactation counselling as an integral part of their programme to improve infant feeding practices. PMID:8706233
Tarrant, Marie; Dodgson, Joan E; Wu, Kendra M
Although more than 85% of all new mothers in Hong Kong now initiate breast feeding, few exclusively breast feed and the overall duration is short. More than one-third stop breast feeding within the first month post partum. To explore the breast-feeding experiences of Hong Kong Chinese mothers who prematurely discontinue breast feeding and to identify contributing factors that might be remediated to help women breast feed longer. Qualitative exploratory study. In-depth, exploratory interviews were carried out with 24 new mothers who stopped breast feeding within one month after birth, and content analysis was used to analyse the data. Five core themes emerged from the data: unnatural expectations, left to figure it out, uncertainty, unfulfilling experiences, and guilt versus relief. Because breast feeding is 'natural' participants expected that it would come naturally and thus be easy. When breast feeding did not happen naturally, however, midwives were too busy to provide breast-feeding support and mothers were left to figure it out on their own. Participants also reported difficulty in gauging whether the infant was getting adequate nutrition from their breastmilk. Few participants had positive breast-feeding experiences; while the decision to stop breast feeding caused guilt for most participants, others expressed relief at stopping breast feeding. Greater postnatal breast-feeding support, both in the hospital and after the mother returns home, would likely increase the mother׳s confidence and enhance her mothering experience. Further antenatal and postnatal education on the realistic breast-feeding expectations and the amount of breastmilk required by babies is also important. More research is needed to test professional and peer support breast-feeding interventions to provide guidance to policy makers on the most effective breast-feeding support strategies. Copyright © 2014 Elsevier Ltd. All rights reserved.
Neifert, M; Gray, J; Gary, N; Camp, B
During a 15-month study period, 244 adolescent mothers under 18 years of age were surveyed, of whom 53% elected to breast-feed. A subset of 60 primiparous breast-feeding adolescents were studied regarding the influence of several factors on the duration of breast-feeding. An attitude questionnaire was administered in the hospital within 48 hours of delivery. Follow-up interviews were obtained by telephone or in person at approximately 2 weeks and 2 months after birth. Eighty-three percent made the decision to breast-feed before the third trimester. Thirty-five percent discontinued breast-feeding within the first postpartum month, the most common reason being "nipple confusion" in the infant; 22% nursed for more than 1 month but less than 2 months, and 43% breast-fed for 2 months or more. None of the variables examined (maternal age, ethnic group, education level, involvement of the baby's father, timing of the breast-feeding decision, intended duration of breast-feeding, age at which formula supplementation was started, or availability of maternal support) was predictive of the duration of breast-feeding. Contrary to adolescent stereotypes, 65% of mothers chose breast-feeding because it was "good for the baby," and 67% identified the "closeness" of the nursing relationship as the most enjoyable part of breast-feeding. Twenty-eight percent cited modesty issues about breast-feeding as the greatest disadvantage, and 17% returned to work or school within the first 2 postpartum months, posing additional obstacles to breast-feeding. Our data suggest that adolescents are receptive to breast-feeding, but they may require close follow-up and anticipatory guidance tailored to their individual needs.(ABSTRACT TRUNCATED AT 250 WORDS)
Erkkola, Maijaliisa; Salmenhaara, Maija; Kronberg-Kippilä, Carina; Ahonen, Suvi; Arkkola, Tuula; Uusitalo, Liisa; Pietinen, Pirjo; Veijola, Riitta; Knip, Mikael; Virtanen, Suvi M
To assess milk feeding on the maternity ward and during infancy, and their relationship to sociodemographic determinants. The validity of our 3-month questionnaire in measuring hospital feeding was assessed. A prospective Finnish birth cohort with increased risk to type 1 diabetes recruited between 1996 and 2004. The families completed a follow-up form on the age at introduction of new foods and age-specific dietary questionnaires. Type 1 Diabetes Prediction and Prevention (DIPP) project, Finland. A cohort of 5993 children (77 % of those invited) participated in the main study, and 117 randomly selected infants in the validation study. Breast milk was the predominant milk on the maternity ward given to 99 % of the infants. Altogether, 80 % of the women recalled their child being fed supplementary milk (donated breast milk or infant formula) on the maternity ward. The median duration of exclusive breast-feeding was 1.4 months (range 0-8) and that of total breast-feeding 7.0 months (0-25). Additional milk feeding on the maternity ward, short parental education, maternal smoking during pregnancy, small gestational age and having no siblings were associated with a risk of short duration of both exclusive and total breast-feeding. In the validation study, 78 % of the milk types given on the maternity ward fell into the same category, according to the questionnaire and hospital records. The recommendations for infant feeding were not achieved. Infant feeding is strongly influenced by sociodemographic determinants and feeding practices on the maternity wards. Long-term breast-feeding may be supported by active promotion on the maternity ward.
Nice, Frank J; Luo, Amy C
To describe the various factors that come into play when a breast-feeding mother is taking medications, including use of prescription drugs, over-the-counter medications, recreational drugs, galactogogues, and herbal remedies and to provide a framework used for counseling breast-feeding women. Community and hospital pharmacy and health care settings. Consultative services provided to breast-feeding mothers who had been prescribed or were using medications. Use of pharmacokinetic factors, maternal and child factors, a list of questions to ask breast-feeding mothers, and a stepwise approach to counsel breast-feeding mothers on the compatibility of using medications while breast-feeding. By positive intervention of pharmacists and health care providers, up to 1 million breast-feeding mothers, who must use medications, can continue to breast-feed while taking medications. Objectively weighing the benefits of drugs and breast-feeding versus the risks of drugs and not breast-feeding, in most cases, allows for pharmacists to give current and practical advice to mothers and other health professionals who counsel mothers.
Hannula, Leena S; Kaunonen, Marja E; Puukka, Pauli J
the aim of this study was to assess the impact of providing intensified support for breast feeding during the perinatal period. a quasi-experimental design with non-equivalent control group. three public maternity hospitals (two study, one control) in the Helsinki Metropolitan area in Finland. a convenience sample of 705 mothers (431 in the intervention group, 274 in the control group). in this study, families in the intervention group had access to intensified breast feeding support from midpregnancy, whereas those in the control group had access to normal care. Intensified support included lectures and workshops to health professionals, and families in the intervention group had access to more intensive support and counselling for breast feeding and a breast feeding outpatient clinic. Additionally, an internet-based intervention was only used in the intervention group, but not in the control group. Mothers in the control group received normal care from the midwifery and nursing professionals who were to continue their work normally. The data were analysed statistically. altogether 705 women participated in the study. In the intervention group (n=431), 76% of the women breast fed exclusively throughout the hospital stay, compared to 66% of the mothers in the control group (n=274). In multivariate analysis, the likelihood of exclusive breast feeding at the time of responding (at hospital discharge or after that at home) was increased by the mother not being treated for an underlying illness or medical problem during pregnancy, being in the intervention group, having normal vaginal childbirth, high breast feeding confidence, positive attitude towards breast feeding, good coping with breast feeding, and 24-hour presence of the infant's father in the ward. the low exclusive breast feeding rates of newborns could be increased by using intensified breast feeding support. Mothers' health problems during pregnancy can decrease exclusive breast feeding. Mothers with health
Sharma, U K; Willingham, F F
Breast-feeding provides nutritional, immunological, and psychological benefits. It protects children from mortality and morbidity associated with diarrheal diseases, pneumonia and other infections. Breast feeding has also been shown to prolong the interval between births and thereby improve child survival and maternal health. However, studies suggest that in certain populations, breast feeding may account for nearly 14% of perinatal human immunodeficiency virus type 1 (HIV-1) transmission. It is therefore important that the risk of HIV-1 infection through breast feeding be weighed against the morbidity and mortality associated with bottle feeding. This paper discusses the literature dealing with breast feeding in women with HIV-1 infection. Specifically, the review addresses the issues surrounding infant mortality in areas of different HIV-1 prevalence where breast-feeding or bottle-feeding may be employed. Analysis suggests that the benefits of breast-feeding or bottle-feeding may be employed. Analysis suggests that the benefits of breast-feeding can substantially outweigh the putative risk of HIV-1 transmission unless the prevalence of HIV-1 infection is high or the difference in mortality between breast-fed and bottle-fed infants is very low.
Patel, Archana; Bucher, Sherri; Pusdekar, Yamini; Esamai, Fabian; Krebs, Nancy F; Goudar, Shivaprasad S; Chomba, Elwyn; Garces, Ana; Pasha, Omrana; Saleem, Sarah; Kodkany, Bhalachandra S; Liechty, Edward A; Kodkany, Bhala; Derman, Richard J; Carlo, Waldemar A; Hambidge, K; Goldenberg, Robert L; Althabe, Fernando; Berrueta, Mabel; Moore, Janet L; McClure, Elizabeth M; Koso-Thomas, Marion; Hibberd, Patricia L
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. 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. 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
Vaaler, Margaret L; Stagg, Julie; Parks, Sharyn E; Erickson, Tracy; Castrucci, Brian C
This study explored the influence of demographic characteristics on attitudes toward the benefits of breast-feeding, approval of public breast-feeding, and the use of infant formula. Additionally, the study examined whether attitudes were related to infant feeding practices among mothers enrolled in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) in Texas. This study used a cross-sectional design. Participants completed questionnaires at WIC clinic sites across Texas. Mothers of young children who were receiving WIC benefits. Attitudes toward the benefits of breast-feeding, attitudes toward public breast-feeding, attitudes toward infant formula, and the choice of infant feeding practice. Descriptive statistics, multivariate ordinary least squares regression, and multinomial logistic regression. A key finding was that many Hispanic mothers held favorable attitudes toward both breast milk and infant formula. Younger and less educated mothers were least likely to agree with the benefits of breast-feeding. Mothers with positive attitudes toward the benefits of breast-feeding were likely to exclusively breastfeed and use both formula and breast milk. Attitudes toward breast-feeding, public breast-feeding, and infant formula and their influence on breast-feeding behavior should inform the curriculum of breast-feeding promotion programs. Published by Elsevier Inc.
Mai, Xiao-Mei; Becker, Allan B; Sellers, Elizabeth A C; Liem, Joel J; Kozyrskyj, Anita L
Breast-feeding is suggested to be associated with overweight or asthma in children. Overweight and asthma may share common environmental influences of which breast-feeding may be one. We evaluated whether short duration of exclusive breast-feeding and subsequent overweight were associated with asthma. A nested case-control study included 246 children with pediatric allergist-diagnosed asthma and 477 controls without asthma at age 8 to 10 years. Information on exclusive breast-feeding was obtained from questionnaire data. Overweight at 8 to 10 years of age was defined as body mass index >/=85th percentile of age and sex-specific growth charts. The association between asthma and exclusive breast-feeding <12 weeks plus overweight, adjusted for sex, parental asthma, aboriginal origin, passive smoking at birth, residence location, and family income, was determined in logistic regression analyses. Exclusive breast-feeding <12 weeks was closely associated with overweight at age 8 to 10 years (P < .001). Exclusive breast-feeding <12 weeks plus overweight was significantly associated with asthma (adjusted OR, 1.81; 95% CI, 1.11-2.95; P = .018). This association appeared to be strong in children whose mothers had asthma (adjusted OR, 3.93; 95% CI, 1.17-13.2) and also in boys (adjusted OR, 2.22; 95% CI, 1.14-4.34). Asthma was not associated with either exclusive breast-feeding <12 weeks or overweight in the absence of the other. Short duration of exclusive breast-feeding and subsequent overweight are associated with asthma in susceptible children, suggesting a common pathway. This finding adds to the importance of promoting prolonged breast-feeding for the prevention of overweight and asthma.
Cardwell, Chris R.; Stene, Lars C.; Ludvigsson, Johnny; Rosenbauer, Joachim; Cinek, Ondrej; Svensson, Jannet; Perez-Bravo, Francisco; Memon, Anjum; Gimeno, Suely G.; Wadsworth, Emma J.K.; Strotmeyer, Elsa S.; Goldacre, Michael J.; Radon, Katja; Chuang, Lee-Ming; Parslow, Roger C.; Chetwynd, Amanda; Karavanaki, Kyriaki; Brigis, Girts; Pozzilli, Paolo; UrbonaitĖ, Brone; Schober, Edith; Devoti, Gabriele; Sipetic, Sandra; Joner, Geir; Ionescu-Tirgoviste, Constantin; de Beaufort, Carine E.; Harrild, Kirsten; Benson, Victoria; Savilahti, Erkki; Ponsonby, Anne-Louise; Salem, Mona; Rabiei, Samira; Patterson, Chris C.
OBJECTIVE To investigate if there is a reduced risk of type 1 diabetes in children breastfed or exclusively breastfed by performing a pooled analysis with adjustment for recognized confounders. RESEARCH DESIGN AND METHODS Relevant studies were identified from literature searches using MEDLINE, Web of Science, and EMBASE. Authors of relevant studies were asked to provide individual participant data or conduct prespecified analyses. Meta-analysis techniques were used to combine odds ratios (ORs) and investigate heterogeneity between studies. RESULTS Data were available from 43 studies including 9,874 patients with type 1 diabetes. Overall, there was a reduction in the risk of diabetes after exclusive breast-feeding for >2 weeks (20 studies; OR = 0.75, 95% CI 0.64–0.88), the association after exclusive breast-feeding for >3 months was weaker (30 studies; OR = 0.87, 95% CI 0.75–1.00), and no association was observed after (nonexclusive) breast-feeding for >2 weeks (28 studies; OR = 0.93, 95% CI 0.81–1.07) or >3 months (29 studies; OR = 0.88, 95% CI 0.78–1.00). These associations were all subject to marked heterogeneity (I2 = 58, 76, 54, and 68%, respectively). In studies with lower risk of bias, the reduced risk after exclusive breast-feeding for >2 weeks remained (12 studies; OR = 0.86, 95% CI 0.75–0.99), and heterogeneity was reduced (I2 = 0%). Adjustments for potential confounders altered these estimates very little. CONCLUSIONS The pooled analysis suggests weak protective associations between exclusive breast-feeding and type 1 diabetes risk. However, these findings are difficult to interpret because of the marked variation in effect and possible biases (particularly recall bias) inherent in the included studies. PMID:22837371
Leon, D A; Ronalds, G
Current evidence, almost exclusively from observational studies, provides a rather mixed picture. From the few studies that have been able to look at fatal or non-fatal cardiovascular events, there is little indication that breast-feeding is associated with either an increased or decreased risk. With respect to blood pressure, the meta-analyses suggest a small but statistically significant lowering of around 1 mmHg SBP associated with having been breast-fed in infancy. However, there is a strong indication from the meta-analyses that even this small effect may partly be accounted for by publication bias. The strongest evidence for an effect of breast-feeding reviewed in this chapter is for serum lipids, where there is good evidence that being breast-fed is associated with an increase in serum total cholesterol in infancy. In childhood there appears to be no association, while in adults there is some indication of breast-feeding being associated with a small decline in total cholesterol levels. As already outlined at the start of the chapter, this whole area of research is made particularly difficult by the fact that breast-feeding can be defined in many different ways. Some studies use definitions that are equivalent to exclusive breast-feeding prior to weaning, while others define it as having ever been breast-fed. This problem of classification is likely to dilute any real associations that may exist. The other major problem is one of interpretation. A result implying that breast-feeding is a "good thing" for cardiovascular health could equally be construed as evidence for a "bad" effect of bottle-feeding. From these data alone, we cannot convincingly determine which conclusion is correct. This is not simply a philosophical debating point. As discussed above in relation to the interpretation of results from the randomised trial of infant feeding, the issue has implications for all research on this topic. Some progress in this area will be made if studies are
Jolly, P E; Humphrey, M; Irons, B Y; Campbell-Forrester, S; Weiss, H L
This study was conducted to examine weight change of exclusively breast-fed infants during the first week and through the first 24 days of life, and to evaluate the effect of breast-feeding factors and maternal characteristics on early weight change in the infants. The weights of 21 infants were recorded on day 1 (day of birth), and on days 3, 7, 10, 17, and 24, and the data analysed to evaluate weight change over the period. Multiple regression analysis was used to assess whether birth weight as well as maternal and breast-feeding factors were significant predictors of weight on day 24. Nineteen of the 21 infants gained weight between days 1 and 3, and 20 infants gained weight between days 3 and 7. All infants gained weight over the 24-day period and their weights at day 7 and day 24 were significantly different (P < 0.05 and P < 0.01, respectively) from their birth weights. Multiple linear regression analysis showed that significant (P < 0.01) predictors of weight gain by day 24 included birth weight, mother's educational level, whether the baby cried before feeding, and length of feeding time periods. This is the first study of weight change in the early days and weeks of life of exclusively breast-fed newborn infants in Jamaica. The infants showed significant weight gain during the study period and weight gain was affected by certain maternal and breast-feeding factors.
Aquilina, Suzanne; Winkelman, Theresa
A recent resurgence of tuberculosis in the world community has brought the disease into the forefront of communicable disease control. Acknowledging the proven benefits of breast-feeding infants, the question of compatibility arises regarding the safety of breast-feeding an infant in the event of active tuberculosis disease in the mother. This article will discuss the emerging trends of tuberculosis disease and review the evidence that addresses the issues of safety while breast-feeding during tuberculosis treatment.
Dearden, Kirk; Altaye, Mekibib; De Maza, Irma; De Oliva, Maritza; Stone-Jimenez, Maryanne; Morrow, Ardythe L; Burkhalter, Barton R
This survey was conducted to identify factors affecting early initiation of breast-feeding and exclusive breast-feeding among mothers in peri-urban Guatemala City, Guatemala. In early November 1999 a census was begun in four communities of peri-urban Guatemala City, Guatemala, to identify all children < 6 months old as well as all pregnant women who were expected to deliver during the two-month data-gathering period. After the census was completed, a survey of breast-feeding practices was administered to all mothers of infants < 6 months of age. The most important determinant of early initiation of breast-feeding was place of delivery. Children born at home (odds ratio (OR) = 4.1, 95% confidence interval (CI): 1.2-13.3) and at Ministry of Health health centers (OR = 4.9, 95% CI: 1.6-15.0) were significantly more likely than children born at private hospitals to initiate breast-feeding early. The most important determinant of exclusive breast-feeding was whether or not the mother worked outside the home. After controlling for infant's age and sex and mother's ethnicity, women who did not work outside the home were 3.2 times as likely (95% CI: 1.6-6.4) to exclusively breast-feed as were women who worked outside the home. Lack of exclusive breast-feeding was often associated with giving a bottle. Our findings suggest that global efforts must be continued to improve breast-feeding practices in delivery hospitals. In addition, community-based support of breast-feeding is needed well after delivery. Mothers who work outside the home should be provided with options to maintain exclusive breast-feeding when they are physically separated from their infants due to the demands of work.
Theofilogiannakou, Melina; Skouroliakou, Maria; Gounaris, Antonis; Panagiotakos, Demosthenis; Markantonis, Sophia L
To determine the prevalence, examine the influence of hospital practices and investigate potential determinants of breast-feeding in Athens. Three hundred twelve mothers provided information regarding feeding practices at certain maternity hospitals in Athens, at 40 days and 6 months postpartum. Multiple logistic regression analysis was performed to evaluate the association between the initiation and maintenance of breast-feeding and potential risk factors. Although almost 90% of newborn infants were given a breast milk substitute one or more times during the first 2 days at the maternity hospital, the exclusive breast-feeding percentage on the last day of hospital stay reached 85%. Breast-feeding and exclusive breast-feeding percentages dropped to 55% and 35%, respectively, at 40 days postpartum and to 16% and 12%, respectively, at 6 months postpartum. While in the hospital, 3% of mothers initiated breast-feeding within 1 hour of labor, only 34% were informed about the advantages of breast-feeding by health professionals and 42% were trained to breast-feed by the midwives. "Rooming-in" was not practiced in the private hospitals. The educational level was positively associated with the initiation of breast-feeding [odds ratio (OR): 1.36, confidence interval (CI): 1.02-1.81], the mother's body mass index was negatively associated with the maintenance of breast-feeding for 40 days (OR: 0.56, CI: 0.32-0.98) and 6 months (OR: 0.28, CI: 0.06-1.26) and a caesarean section was negatively associated with the initiation (OR: 0.24, CI: 0.11-0.49) and maintenance of breast-feeding (OR: 0.42, CI: 0.20-0.89). Breast-feeding is not appropriately supported in certain maternity hospitals in Athens, and this is probably the cause of observed low breast-feeding prevalence.
Meeting mothers' personal breast-feeding goals depends on a number of factors, including the timely resolution of any problems she encounters. Nurses are often the first providers who interact with the mother during the perinatal period and are positioned to guide mothers through the prevention and solving of breast-feeding problems. Although many problems may be "common," failure to remedy conditions that cause pain, frustration, and anxiety can lead to premature weaning and avoidance of breast-feeding subsequent children. This article describes strategies and interventions to alleviate common problems that breast-feeding mothers frequently encounter.
Harrison, M J; Morse, J M; Prowse, M
A content analysis of 141 articles on breast feeding by discipline revealed differences in the factors considered necessary for breast feeding success and in the criteria used to determine success. Whereas medical articles focused on maternal factors prenatally and infant health post-natally, or the length of time breast feeding was maintained, lay articles focused on the relationship of the mother with her infant (the nursing couple) and the mother's ability to manage breast feeding within the family context. The implications of this discrepancy for nursing practice and research are discussed.
Moreland, J; Coombs, J
The family physician can significantly influence a mother's decision to breast-feed. Prenatal support, hospital management and subsequent pediatric and maternal visits are all-important components of breast-feeding promotion. Prenatal encouragement increases breast-feeding rates and identifies potential problem areas. Hospital practices should focus on rooming-in, early and frequent breast-feeding, skilled support and avoidance of artificial nipples, pacifiers and formula. Infant follow-up should be two to four days postdischarge, with liberal use of referral and support groups, including lactation consultants and peer counselors.
Camune, Barbara; Gabzdyl, Elizabeth
According to the American Cancer Society in 2007, about 178,000 women are diagnosed with breast cancer each year in the United States. Of these, 25% have tumors in their childbearing years and may desire future opportunities for pregnancy and lactation. Although there is a multitude of options related to preserving fertility, little is known about the residual effects of breast cancer treatment and the ability to breast-feed afterward. This article describes the epidemiological relationship between breast cancer and pregnancy and lactation. Basic types of treatment for breast cancer including surgery, chemotherapy, and radiation are reviewed. Practical information on how to support breast-feeding after breast cancer is included.
Tao, Xing-Yong; Huang, Kun; Yan, Shuang-Qin; Zuo, A-Zhu; Tao, Rui-Wen; Cao, Hui; Gu, Chun-Li; Tao, Fang-Biao
The purpose of the present study was to examine the influence of maternal pre-pregnancy BMI and gestational weight gain (GWG) on initiation and duration of infant breast-feeding in a prospective birth cohort study. Breast-feeding information was collected at 1, 3, 6 and 12 months postpartum. The association of pre-pregnancy BMI and GWG with delayed lactogenesis II and termination of exclusive breast-feeding was assessed with logistic regression analysis. The risk of early termination of any breast-feeding during the first year postpartum was assessed with Cox proportional hazards models. Urban city in China. Women with infants from the Ma'anshan Birth Cohort Study (n 3196). The median duration of any breast-feeding in this cohort was 7·0 months. Pre-pregnancy obese women had higher risks of delayed lactogenesis II (risk ratio=1·89; 95 % CI 1·04, 3·43) and early termination of any breast-feeding (hazard ratio=1·38; 95 % CI 1·09, 1·75) adjusted for potential maternal and infant confounders, when compared with normal-weight women. No differences in breast-feeding initiation or duration of exclusive breast-feeding according to pre-pregnancy BMI were found. Moreover, GWG was not associated with any poor breast-feeding outcomes. The present study indicated that pre-pregnancy obesity increases the risks of delayed lactogenesis II and early termination of any breast-feeding in Chinese women.
Fängström, Britta; Moore, Sophie; Nermell, Barbro; Kuenstl, Linda; Goessler, Walter; Grandér, Margaretha; Kabir, Iqbal; Palm, Brita; Arifeen, Shams El; Vahter, Marie
Chronic arsenic exposure causes a wide range of health effects, but little is known about critical windows of exposure. Arsenic readily crosses the placenta, but the few available data on postnatal exposure to arsenic via breast milk are not conclusive. Our goal was to assess the arsenic exposure through breast milk in Bangladeshi infants, living in an area with high prevalence of arsenic-rich tube-well water. We analyzed metabolites of inorganic arsenic in breast milk and infant urine at 3 months of age and compared them with detailed information on breast-feeding practices and maternal arsenic exposure, as measured by concentrations in blood, urine, and saliva. Arsenic concentrations in breast-milk samples were low (median, 1 microg/kg; range, 0.25-19 microg/kg), despite high arsenic exposures via drinking water (10-1,100 microg/L in urine and 2-40 microg/L in red blood cells). Accordingly, the arsenic concentrations in urine of infants whose mothers reported exclusive breast-feeding were low (median, 1.1 microg/L; range, 0.3-29 microg/L), whereas concentrations for those whose mothers reported partial breast-feeding ranged from 0.4 to 1,520 microg/L (median 1.9 microg/L). The major part of arsenic in milk was inorganic. Still, the infants had a high fraction (median, 87%) of the dimethylated arsenic metabolite in urine. Arsenic in breast milk was associated with arsenic in maternal blood, urine, and saliva. Very little arsenic is excreted in breast milk, even in women with high exposure from drinking water. Thus, exclusive breast-feeding protects the infant from exposure to arsenic.
Fängström, Britta; Moore, Sophie; Nermell, Barbro; Kuenstl, Linda; Goessler, Walter; Grandér, Margaretha; Kabir, Iqbal; Palm, Brita; Arifeen, Shams El; Vahter, Marie
Background Chronic arsenic exposure causes a wide range of health effects, but little is known about critical windows of exposure. Arsenic readily crosses the placenta, but the few available data on postnatal exposure to arsenic via breast milk are not conclusive. Aim Our goal was to assess the arsenic exposure through breast milk in Bangladeshi infants, living in an area with high prevalence of arsenic-rich tube-well water. Methods We analyzed metabolites of inorganic arsenic in breast milk and infant urine at 3 months of age and compared them with detailed information on breast-feeding practices and maternal arsenic exposure, as measured by concentrations in blood, urine, and saliva. Results Arsenic concentrations in breast-milk samples were low (median, 1 μg/kg; range, 0.25–19 μg/kg), despite high arsenic exposures via drinking water (10–1,100 μg/L in urine and 2–40 μg/L in red blood cells). Accordingly, the arsenic concentrations in urine of infants whose mothers reported exclusive breast-feeding were low (median, 1.1 μg/L; range, 0.3–29 μg/L), whereas concentrations for those whose mothers reported partial breast-feeding ranged from 0.4 to 1,520 μg/L (median 1.9 μg/L). The major part of arsenic in milk was inorganic. Still, the infants had a high fraction (median, 87%) of the dimethylated arsenic metabolite in urine. Arsenic in breast milk was associated with arsenic in maternal blood, urine, and saliva. Conclusion Very little arsenic is excreted in breast milk, even in women with high exposure from drinking water. Thus, exclusive breast-feeding protects the infant from exposure to arsenic. PMID:18629322
Tarrant, Roslyn C; Kearney, John M
Breast-feeding is the superior infant feeding method from birth, with research consistently demonstrating its numerous short- and long-term health benefits for both mother and infant. As a global recommendation the WHO advises that mothers should exclusively breast-feed for the first 6-months of life, thus delaying the introduction of solids during this time. Historically, Irish breast-feeding initiation rates have remained strikingly low in comparison with international data and there has been little improvement in breast-feeding duration rates. There is wide geographical variation in terms of breast-feeding initiation both internationally and in Ireland. Some of these differences in breast-feeding rates may be associated with differing socio-economic characteristics. A recent cross-sectional prospective study of 561 pregnant women attending a Dublin hospital and followed from the antenatal period to 6 months post partum has found that 47% of the Irish-national mothers initiated breast-feeding, while only 24% were still offering 'any' breast milk to their infants at 6 weeks. Mothers' positive antenatal feeding intention to breast-feed is indicated as one of the most important independent determinants of initiation and 'any' breast-feeding at 6 weeks, suggesting that the antenatal period should be targeted as an effective time to influence and affect mothers' attitudes and beliefs pertaining to breast-feeding. These results suggest that the 'cultural' barrier towards breast-feeding appears to still prevail in Ireland and consequently an environment that enables women to breast-feed is far from being achieved. Undoubtedly, a shift towards a more positive and accepting breast-feeding culture is required if national breast-feeding rates are to improve.
Kondolot, Meda; Yalçin, S Songül; Yurdakök, Kadriye
The aim of the present study was to examine the effects of breast-feeding method (on only one or on two sides in a single feeding session) on growth, sleep duration and sucking period, and stool frequency. Exclusively breast-fed healthy infants, aged 1-6 months, were included in the study during child health follow-up visits. Mothers were given a questionnaire on sleep duration, sucking periods, and stool frequencies of their infants. The height-for-age and weight-for-age z scores were significantly higher in infants breast-fed from one side during a single session than from both sides (P= 0.002, P < 0.001; respectively). Infants sucking on only one breast in a breast-feeding session defecated significantly less at night (P= 0.005), their maximum sucking periods at night were shorter (P= 0.049). Breast-feeding at one side only during a single breast-feeding session increases growth, decreases stool frequency and the maximum sucking period at night and does not influence the overall sleep pattern.
Heikkilä, Katriina; Sacker, Amanda; Kelly, Yvonne; Renfrew, Mary J; Quigley, Maria A
To examine whether breast feeding is associated with behavioural development in children aged 5 years. The authors used data from a large, prospective, nationally representative UK cohort, the Millennium Cohort Study. 10 037 mother-child pairs from white ethnic background (9525 term and 512 preterm children) were included in the analyses. Duration of breast feeding (at all or exclusively) was ascertained from parental interview at study baseline, when the children were aged 9 months. Child behaviour was assessed using a parent-completed questionnaire, the Strengths and Difficulties Questionnaire (SDQ). The authors used logistic regression to investigate the associations of breastfeeding duration with abnormal parent-rated SDQ total and subscores at age 5 in term and preterm children separately. Abnormal SDQ scores were less common in term children (n=1129/9525, 12%) than pre-term (n=78/512, 15%) children. Term children breast fed for 4 months or longer (n=2741/9525, 29%) had lower odds of an abnormal total SDQ score (multivariable-adjusted OR compared with never breastfed children (n=3292/9525, 35%) 0.67, 95% CI: 0.54 to 0.83). This effect was similar for all the SDQ subscores. In preterm children, longer duration of breast feeding was generally associated with lower odds of abnormal SDQ total and subscores but the effect estimates were imprecise. The associations between exclusive breast feeding and abnormal SDQ scores were similar to those of any breast feeding and abnormal SDQ scores. The findings suggest that, at least in term children, longer duration of breast feeding is associated with fewer parent-rated behavioural problems in children aged 5 years.
Assis, A M; Prado, M da S; Freitas, M do C; Silva, R de C; Ramos, L B; Machado, A D
A Research project in the establishment and duration of total and exclusive breast-feeding in rural communities of Cansação, BA, Brazil, is presented. It included 226 children, from zero to two years old, of families of peasants living on small-holdings in one of the driest and poorest regions of the Brazilian Northeast. The data were collected through questionnaires answered by mothers or any adult responsible for the child during 1988 and 1989. It relates to all children from these families who were two years of age at the time of the study. The survival time was the statistical method used to calculate the median duration of breast-feeding; 91.6% of the 226 children started to be breast-fed. This finding shows that the establishment of the breast-feeding was high. The median duration of total breast-feeding was of 90.28 days and exclusive breast-feeding presented a median duration of 0.1 day. Through the establishment of breast-feeding can be considered high, the median duration of total breast-feeding is extremely short and that of exclusive breast-feeding insignificant.
Thurston, Amanda; Bolin, Jocelyn H; Chezem, Jo Carol
The purpose was to describe sources of infant formula samples during the perinatal period and assess their associations with breast-feeding outcomes at 1 month postpartum. Subjects included expectant mothers who anticipated breast-feeding at least 1 month. Infant feeding history and sources of formula samples were obtained at 1 month postpartum. Associations between sources and breast-feeding outcomes were assessed using partial correlation. Of the 61 subjects who initiated breast-feeding, most were white (87%), married (75%), college-educated (75%), and planned exclusive breast-feeding (82%). Forty-two subjects (69%) continued breast-feeding at 1 month postpartum. Subjects received formula samples from the hospital (n = 40; 66%), physician's office (n = 10; 16%), and mail (n = 41; 67%). There were no significant correlations between formula samples from the hospital, physician's office, and/or mail and any or exclusive breast-feeding at 1 month (P > .05). In addition to the hospital, a long-standing source of formula samples, mail was also frequently reported as a route for distribution. The lack of statistically significant associations between formula samples and any or exclusive breast-feeding at 1 month may be related to small sample size and unique characteristics of the group studied.
Doan, Therese; Gardiner, Annelise; Gay, Caryl L; Lee, Kathryn A
This study describes sleep patterns for mothers and fathers after the birth of their first child and compares exclusive breast-feeding families with parents who used supplementation during the evening or night at 3 months postpartum. As part of a randomized clinical trial, the study utilized infant feeding and sleep data at 3 months postpartum from 133 new mothers and fathers. Infant feeding type (breast milk or formula) was determined from parent diaries. Sleep was measured objectively using wrist actigraphy and subjectively using diaries. Lee's General Sleep Disturbance Scale was used to estimate perceived sleep disturbance. Parents of infants who were breastfed in the evening and/or at night slept an average of 40-45 minutes more than parents of infants given formula. Parents of infants given formula at night also self-reported more sleep disturbance than parents of infants who were exclusively breast-fed at night. Parents who supplement their infant feeding with formula under the impression that they will get more sleep should be encouraged to continue breast-feeding because sleep loss of more than 30 minutes each night can begin to affect daytime functioning, particularly in those parents who return to work.
Pontes, Cleide M; Osório, Mônica M; Alexandrino, Aline C
to analyse the opinions of men and women on the father's participation in breast feeding. a qualitative and exploratory study, using the content analysis method, on its thematic modality. Data were collected at discussion groups that answered the following questions: which meanings and feelings are related to father's involvement in breast feeding? Which factors help or obstruct the act of breast feeding? How do fathers participate in breast feeding? three discussion groups took place during the event 'The man as an ally in breast feeding process: is that the question?', supported by the Federal University of Pernambuco, Brazil. 11 men and nine women attended the event. Of the men, two had more than one child and five had babies who were being breast fed. Among the women, all were mothers and three were breast feeding. four thematic nuclei emerged from the performed analysis, which was also based in the historical, social and cultural process of fatherhood: involvement in the pregnancy-puerperal cycle; feelings and meanings of breast feeding; meanings of breast feeding in public; and ways to include father in the breast-feeding process. fathers participating in breast feeding considered it to be a brief period in the process of fatherhood. Behaviours of ambivalence, conflict, exclusion, insecurity and concern towards breast feeding were revealed. There was a perception of the nursing mother as a sexless being. However, the participants also suggested ways of including fathers in the process of breast feeding. According to the participants, they could (1) provide a favourable environment for the mother and baby; (2) participate more during pregnancy and birth; (3) help with domestic chores; (4) develop parenthood; and (5) be present during breast feeding. These suggestions may function as foundations for health staff to develop programmes, in order to involve fathers in breast feeding. This could result in a contribution to improve the practice and duration of that
Armstrong, Julie; Abraham, Elizheeba Christie; Squair, Mhairi; Brogan, Yvonne; Merewood, Anne
Limited data exist that explore the association between exclusive breastfeeding and dietary behaviors related to key food choices in later infancy. This study aimed to examine the relationship between exclusive breastfeeding at 3 months with age of starting complementary feeding and key complementary feeding data collected at 8 to 10 months. Secondary data analysis was performed on the UK Infant Feeding Survey 2005. After adjusting for maternal characteristics, exclusive breastfeeding for 3 months, compared to mixed or formula feeding, was positively associated with giving homemade infant foods (adjusted odds ratio [AOR] = 1.41; 95% confidence interval [CI], 1.19-1.66), vegetables (AOR = 1.46; 95% CI, 1.25-1.72), fruits (AOR = 1.73; 95% CI, 1.42-2.11), and fresh foods frequently (AOR = 2.24; 95% CI, 1.41-3.56) at 8 to 10 months of age. Conversely, exclusive breastfeeding for 3 months, compared to mixed or formula feeding, was negatively associated with very early complementary feeding (AOR = 0.35; 95% CI, 0.30-0.42) and giving the following foods at 8 to 10 months of age: baby food from jar (AOR = 0.78; 95% CI, 0.66-0.92), powdered baby food (AOR = 0.73; 95% CI, 0.57-0.94), canned baby food (AOR = 0.48; 95% CI, 0.32-0.71), and ready-made bought meals (AOR = 0.67; 95% CI, 0.57-0.78). Exclusively breastfeeding for 3 months compared to mixed or formula feeding was positively associated with the introduction of complementary feeding after 4 months and giving infants fruits, vegetables, and homemade infant foods frequently at 8 to 10 months.
Hawley, Nicola L; Rosen, Rochelle K; Strait, E Ashton; Raffucci, Gabriela; Holmdahl, Inga; Freeman, Joshua R; Muasau-Howard, Bethel T; McGarvey, Stephen T
In American Samoa, initiation of breastfeeding is almost universal but exclusive breastfeeding, a promising target for obesity prevention, is short in duration. (1) To examine American Samoan mothers' feeding experiences and attitudes and beliefs about infant feeding and (2) to identify potential barriers to exclusive breastfeeding. Eighteen semi-structured interviews were conducted with American Samoan mothers at 16-32 days postpartum. Interviews focused on mother's knowledge and beliefs about infant feeding, how their infants were fed, why the mother had chosen this mode of infant feeding, and how decisions about feeding were made within her social surroundings. A thematic qualitative analysis was conducted to identify salient themes in the data. Intention to exclusively breastfeed did not predict practice; most women supplemented with formula despite intending to exclusively breastfeed. The benefits of breastfeeding were well-recognized, but the importance of exclusivity was missed. Formula-use was not preferred but considered an innocuous "back-up option" where breastfeeding was not possible or not sufficient for infant satiety. Identified barriers to exclusive breastfeeding included: the convenience of formula; perceptions among mothers that they were not producing enough breast milk; and pain while breastfeeding. The important support role of family for infant feeding could be utilized in intervention design. This study identified barriers to exclusive breastfeeding that can be immediately addressed by providers of breastfeeding support services. Further research is needed to address the common perception of insufficient milk in this setting. Copyright © 2015 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.
Chen, Ying-Juang; Yeh, Tsu-Fu; Chen, Chung-Ming
Hyperbilirubinemic neonates have significantly less bodyweight gain from nursery discharge to outpatient department (OPD) follow up. We tested the hypothesis that discharge instructions encouraging frequent breast-feeding given in the nursery would increase infant bodyweight gain and decrease the incidence of hyperbilirubinemia. We enrolled consecutively live-born neonates who were discharged from the nursery and who received OPD follow up within the first 2 weeks of birth in 2011. The nursing staff discussed the discharge instructions with the parents at the time of nursery discharge. Parents were asked to fill in a nursing information form to record the frequency of breast-feeding and diaper change per day. Parents of 98 breast-fed term neonates provided complete nursing information forms. These 98 neonates were classified into two groups according to breast-feeding frequency, namely <8 times/day (63 neonates) and ≥8 times/day (35 neonates). A significant positive correlation between breast-feeding frequency and diaper change frequency per day indicated that the data were highly reliable. The gestational age, Apgar score, birthweight, and bodyweight at nursery discharge and at OPD were similar between the two groups. Neonates who were breast-fed ≥8 times/day had a significantly lower incidence of hyperbilirubinemia. Nursery discharge instructions that encouraged mothers to breast-feed their newborns frequently decreased the rate of hyperbilirubinemia in exclusively breast-fed term neonates. © 2015 Japan Pediatric Society.
Shank, Jessica J; Olney, Stacey C; Lin, Fang L; McNamara, Michael F
Anaphylaxis associated with breast-feeding is a rare but potentially life-threatening event. This woman reported anaphylaxis with three previous pregnancies while breast-feeding. With her fourth pregnancy she was treated with corticosteroids and antihistamines after delivery. Despite treatment, she developed urticaria, facial edema, and throat tightening, less severe than prior episodes. Her symptoms resolved with epinephrine and antihistamine but recurred with subsequent breast-feeding. On postpartum day 4 she had no symptoms while breast-feeding. Three cases of postpartum breast-feeding anaphylaxis have been reported. Although the pathophysiology is unclear, it may involve the decrease in progesterone and rise of prolactin causing mast cell degranulation. Avoidance of nonsteroidal antiinflammatories and prophylaxis with corticosteroids and antihistamines may offer the best protection.
Popkin, B M; Adair, L; Akin, J S; Black, R; Briscoe, J; Flieger, W
This study used a unique longitudinal survey of more than 3000 mother-infant pairs observed from pregnancy through infancy. The sample is representative of infants from the Cebu region of the Philippines. The sequencing of breast-feeding and diarrheal morbidity events was carefully examined in a longitudinal analysis which allowed for the examination of age-specific effects of feeding patterns. Because the work controlled for a wide range of environmental causes of diarrhea, the results can be generalized to other populations with some confidence. The addition to the breast-milk diet of even water, teas, and other nonnutritive liquids doubled or tripled the likelihood of diarrhea. Supplementation of breast-feeding with additional nutritive foods or liquids further increased significantly the risk of diarrhea; most benefits of breast-feeding alone or in combination with nutritive foods/liquids became small during the second half of infancy. Benefits of breast-feeding were slightly greater in urban environments.
A mother who breast-feeds makes a significant contribution to her infant's health. Currently researchers are delineating many of the unique nutritional and antiinfective factors in human milk. The psychological advantages that accrue to both the breast-feeding mother and her infant are harder to quantify. Contraindications to breast-feeding are few and relate primarily to maternal illness and need for medications, or to those rare infants who have inborn errors of metabolism. Physicians and other health personnel should advise the mother knowledgeably on breast-feeding and seek imaginative solutions to any problems so that breast-feeding can be continued well into the first year of the infant's life and into following years if both mother and child desire it.
Yu, Elaine A; Thomas, Joan S; Owais, Aatekah; Tirmizi, Noor; Faruque, Asg; Das, Sumon K; Rahman, Shahed; Schwartz, Benjamin; Stein, Aryeh D
To assess the relationships between maternal breast-feeding intention, attitudes, self-efficacy and knowledge at 7 months' gestation with exclusive or full breast-feeding at 3 months postpartum. Prospective cohort study with structured home interviews during pregnancy and 3 months after delivery. Two rural sub-districts of Kishoreganj district, Bangladesh. Mother-infant dyads. Over 80 % of 2178 pregnant women intended to exclusively breast-feed (EBF). Maternal positive attitudes, self-efficacy and knowledge about breast-feeding were positively associated with EBF intention (all P<0.05). All mothers except one reported initiating breast-feeding and 99.6 % of children were still breast-fed at 3 months. According to 24 h dietary recalls, we categorized 985 (45.2 %) infants as EBF at 3 months (47.8 % among mothers with EBF intention; 31.7 % among mothers with no EBF intention; P<0.05) and 551 (25.3 %) infants as predominantly breast-fed at 3 months (24.2 % among mothers with EBF intention; 30.8 % among mothers with no EBF intention; P<0.05). Prenatal EBF intention was associated with EBF (OR=1.48, 95 % CI 1.14, 1.91) and with full breast-feeding (OR=1.34, 95 % CI 1.04, 1.72) at age 3 months. EBF at age 3 months was not associated with maternal breast-feeding knowledge, attitudes or self-efficacy. Despite widespread expressed maternal EBF intention and universal breast-feeding initiation, prevalence of both exclusive and full breast-feeding at 3 months remains lower than WHO recommendations. EBF intention predicts breast-feeding behaviours, suggesting the importance of prenatal counselling to improve infant feeding behaviours.
Kasinga, F; Mogotlane, S M; van Rensburg, G H
Although breast-feeding is nature's way of providing nutrition to the baby, in HIV positive mothers this has been identified as one of the means through which HIV infection is transmitted from the mother to the child. In Africa where children under the age of 5 are killed by preventable diseases like diarrhoea, the issue of HIV transmission through breast feeding poses an added huge problem. Research has, however shown that exclusive infant feeding, be it breast or formula, reduces the risk substantially. It is imperative that mothers be informed about safer methods of infant feeding so that HIV infection is kept to a minimum. The objective of the study was to explore and describe the knowledge that pregnant women had about mother to child transmission of HIV infection through breast-feeding. A non-experimental quantitative exploratory and descriptive research design was used to explore the knowledge women had on mother to child transmission of HIV infection through breast-feeding. From the data collected, it showed that although women were aware of the susceptibility of children to HIV infection if fed on breast and formula feeds simultaneously by HIV positive mothers, exclusive feeding was a problem as people associated the practise with a positive HIV status. Women who had not disclosed their HIV status and were HIV positive, found it difficult to comply with the requirement to exclusively feed their infants. These either continued with complementary feeds or did not collect the free formula milk supply preferring instead to buy the formula feeds privately. In this study it was recommended that information on transmission of HIV infection from mother to child through breast -feeding including the benefits of exclusive infant feeding, be it breast or formula, for the first three to six months be provided to the community so that relatives can support the mother on infant feeding method of choice.
Wallace, Helen; Clarke, Susan
Tongue tie is a congenital oral abnormality characterised by an abnormally short lingual frenulum. The majority of current medical and surgical opinion is that tongue tie rarely, if ever, causes feeding difficulties and therefore, should not be divided. With increased popularity of breast feeding in the last decade there has been renewed interest in tongue tie and its effect on breast feeding. We present a case series of infants who underwent tongue tie division for feeding difficulties and assess the indications for and outcomes of the procedure. Eleven infants with breast feeding difficulties associated with tongue tie underwent tongue tie division using a standard technique in the outpatient clinic. No anaesthetic or analgesia was used and there was little or no bleeding or infant distress. Parents were subsequently contacted by phone at least 4 months after the procedure to inquire about the effect of the procedure on feeding and any complications encountered. The age at tongue tie division ranged from 2 to 31 days (median=10 days). 10/11 of these infants were followed up. The age at follow up was 4-20 months (median=10 months). Prior to division, all mothers had attempted breast feeding and were keen to continue. 9/10 had experienced difficulties due to poor latch (8/10), sore nipples (6/10) and continual feeding cycle (5/10). Only 3/10 mothers were breast feeding exclusively. Following tongue tie division, an improvement in breast feeding was noticed immediately by 4/10 mothers. Three mothers did not notice any improvement. 6/10 mothers successfully breast fed for at least 4 months. There were no reported complications of the procedure. The benefits of breast feeding are well known and lactation consultants are becoming more aware of tongue tie as a treatable cause of breast feeding difficulty. The procedure is quick and simple, not requiring any analgesia or anaesthesia and can be performed in the outpatient clinic. Although not conclusive, this case series
More than 90% of women in developing countries and 50 to 90% of women in industrialized countries now initiate breast-feeding, a marked improvement from 25 y ago. The duration of breast-feeding has lengthened, but fewer than 35% of infants worldwide are still exclusively breast-fed at 4 mo of age. C...
Kull, Inger; Böhme, Maria; Wahlgren, Carl-Fredrik; Nordvall, Lennart; Pershagen, Göran; Wickman, Magnus
The evidence for a preventive effect of breast-feeding on the development of eczema in childhood remains controversial. To investigate the effect of breast-feeding in various phenotypes of eczema to 4 years. A birth cohort of 4089 children made up the study base. Data on breast-feeding, allergic symptoms, and potential confounders were obtained from questionnaires when the children were 2 months and 1, 2, and 4 years old. At 4 years, blood specific IgE was analyzed. Children with symptoms of eczema and asthma during the period of breast-feeding were excluded in most analyses on risk assessment of eczema and asthma, respectively, to avoid disease-related modification of exposure. Exclusive breast-feeding for >or=4 months reduced the risk for eczema at the age of 4 years (odds ratio [OR], 0.78; 95% CI, 0.63--0.96) irrespective of combination with asthma, sensitization to common allergens, or parental allergic disease. This decreased risk was most evident for children with onset of eczema during the first 2 years persisting to 4 years (OR, 0.59; 95% CI, 0.45--0.77). Among children with early-onset eczema, irrespective of persistency, followed by late onset of asthma or early-onset asthma irrespective of persistency, followed by late-onset eczema to 4 years, a protective effect of breast-feeding was also seen (OR, 0.48; 95% CI, 0.30--0.76). Breast-feeding 4 months or more reduces the risk for eczema and onset of the allergy march to age 4.
Iglesias Fernández, C; Chimenti Camacho, P; Vázquez López, P; Guerrero Soler, M; Blanco Bravo, D
Complete aortic thrombosis is rare in neonates. Because it carries high morbidity and mortality, this entity requires aggressive and early treatment. This report describes an 8-day-old healthy and exclusively breast-fed infant, without specific coagulopathy, who developed complete aortic and cerebral venous thrombosis, which was attributed to inadequate breast-feeding and severe hypernatremic dehydration. Early systemic anticoagulation and thrombolytic therapy allowed complete resolution of the problem.
Albernaz, Elaine; Victora, Cesar G; Haisma, Hinke; Wright, Antony; Coward, William A
The importance of exclusive breast-feeding in the first 6 mo of life is widely recognized, but most mothers still do not reach this goal. Several studies have shown that face-to-face lactation counseling is effective in increasing not only exclusive breast-feeding rates but also the total duration of breast-feeding. However, it is unclear whether counseling could increase breast milk intake. The purpose of this study was to evaluate the effect of lactation counseling on breast milk intake, assessed through the deuterium dilution method. This was a blind, randomized intervention trial of lactation counseling in a sample of 188 babies born in Pelotas, selected with the same criteria used for the WHO Multicentre Growth Reference Study (MGRS). The main outcomes were breast-feeding pattern and duration for all infants as well as breast milk intake for a subsample of 68 infants at the age of 4 mo. Mothers in the control group were almost twice as likely to stop breast-feeding by 4 mo as those in the intervention group (prevalence ratio 1.85; P = 0.04). Cox regression confirmed that the velocity of weaning was twice as high in the control group. Breast milk and total water intakes did not differ between the groups. The deuterium dilution technique proved to be a practical means of assessing breast milk intake. Lactation counseling reduced early weaning, but breast milk intake at 4 mo was not affected.
Gill, Sara L; Reifsnider, Elizabeth; Lucke, Joseph F; Mann, Angela R
Current breast-feeding rates fall short of the recommendations set forth in Health People 2010. The Breast-feeding Attrition Prediction Tool (BAPT), administered in the postpartum period, has been useful in predicting breast-feeding attrition. However, assessing a woman's intention to breast-feed prior to birth would identify women at risk for breast-feeding attrition. The purpose of this study was to describe a revised BAPT, administered antepartally that measures intention to breast-feed. The BAPT, comprising 94 items on a 6-point Likert-type scale, was translated into Spanish and back-translated for accuracy. The BAPT was then revised by reducing the number of items to 35 (32 were used for analysis) and contracting the 6-point scale to 3 categories. A Bayesian item response model provided the psychometric properties of the revised BAPT. The revised BAPT was completed by 143 Mexican American pregnant women. Items, some reverse scored, were recoded as "agree" versus "disagree." Item analyses indicated a wide range of item discriminabilities, with most items being useful measures of intention to breast-feed. Person analyses provided scores for intention to breast-feed. A simpler scoring system was devised for applications. The revised BAPT shows promise as a measure of intention to breast-feed. The scoring system also indicates which women may need additional interventions to promote breast-feeding.
Al-Farsi, Yahya M; Al-Sharbati, Marwan M; Waly, Mostafa I; Al-Farsi, Omar A; Al-Shafaee, Mohammed A; Al-Khaduri, Maha M; Trivedi, Malav S; Deth, Richard C
To evaluate the association between suboptimal breast-feeding practices and autism spectrum disorders (ASDs). A case-control study was conducted in 102 ASD cases and 102 matched healthy controls. Based on adjusted odds ratios from logistic regression models, ASD was found to be associated with the late initiation of breast-feeding (odds ratio 1.48, 95% confidence interval 1.01-3.1), a non-intake of colostrum (odds ratio 1.7, 95% confidence interval 1.03-4.3), prelacteal feeding, and bottle-feeding. The risk of ASD was found to decrease in a dose-response fashion over increasing periods of exclusive breast-feeding (P for trend = 0.04) and continued breast-feeding (P for trend = 0.001). The study indicates that increased ASD risk is generally associated with suboptimal breast-feeding practices. Copyright © 2012 Elsevier Inc. All rights reserved.
Anchondo, Inés; Berkeley, Lizabeth; Mulla, Zuber D; Byrd, Theresa; Nuwayhid, Bahij; Handal, Gilbert; Akins, Ralitsa
Investigate physicians' breast-feeding experiences and attitudes using a survey based on two behavioral theories: theory of reasoned action (TRA) and the health belief model (HBM). There were 73 participants included in the investigation. These participants were resident and faculty physicians from pediatrics, obstetrics/gynecology, and family medicine at a university campus, located on the US-Mexico border. The sample was reduced to 53 and 56 records for the attitude and confidence variables, respectively. Physicians answered a survey about their breast-feeding experiences and attitudes to learn about intention and ability applying constructs from TRA and HBM. An attitude scale, confidence variable (from self-efficacy items), and a lactation training index were created for the analysis. Analysis of the association between physicians' breastfeeding experiences and their attitudes revealed physicians are knowledgeable about breast-feeding and have positive attitudes towards breast-feeding. They did not seem to remember how long they breast-fed their children or whether they enjoyed breast-feeding, but they wanted to continue breast-feeding. Physicians cite work as a main reason for not continuing to breast-feed. Physicians' attitudes toward breast-feeding are positive. They are expected to practice health-promotion behavior including breast-feeding; however, physicians' breast-feeding rates are low and although they are knowledgeable about breast-feeding their training lacks on didactic depth and hands-on experience. If physicians learn more about breast-feeding and breast-feed exclusively and successfully, the rates in the United States would increase naturally.
Tavoulari, Evangelia-Filothei; Benetou, Vassiliki; Vlastarakos, Petros V; Andriopoulou, Eirini; Kreatsas, George; Linos, Athena
to investigate the association between breast-feeding initiation and socio-demographic, lifestyle-related, clinical and lactation-related factors in a sample of mothers living in Greece. cross-sectional study. Tertiary University Hospital, maternity ward. 428 mothers were interviewed (43.2% response rate) from February until December 2009, using a structured face-to-face questionnaire after at least 24 hours from childbirth. 71.0% of mothers were Greeks and 29.0% immigrants; the mean age was 32.0 years. 44.4% initiated exclusive breast feeding, 7.9% artificial milk -feeding and 47.7% partial feeding. In the multivariate analysis, exclusive breast feeding was inversely related to maternal body mass index (BMI) at the beginning of gestation (odds ratio (OR)=0.93, 95% confidence intervals (95%CI)=0.89-0.98) and caesarean section (OR=0.54, 95% CI=0.35-0.84). Lactation-related factors which favourably affected exclusive breast-feeding initiation included previous breast-feeding experience (OR=2.29, 95% CI=1.39-3.78), information about breast feeding (OR=2.38, 95% CI=1.41-4.01) and rooming-in (OR=1.62 95% CI=1.03-2.54), whilst any breast feeding was favourably affected by encouraging women to breast feed (OR=5.42, 95% CI=1.90-15.50), providing information about breast feeding (OR=6.92, 95% CI=2.53-18.89), and rooming-in (OR=6.93 95% CI=2.01-23.88), and negatively associated with caesarean section (OR=0.11, 95% CI=0.03-0.39). Being an immigrant mother was also positively associated with any breast-feeding initiation (OR=7.97, 95% CI=1.02-62.19). Maternal age, education and income, as well as, smoking status, were not associated with any breast-feeding initiation. maternal BMI and immigrant status, information provided by midwives and encouragement, rooming-in and mode of childbirth (caesarean section), were found to be important for breast-feeding initiation in this study population. No other indicator of socio-demographic status was found to be associated with breast-feeding
Chagas disease (infection by the protozoan Trypanosoma cruzi) is a major parasitic disease of the Americas and one of the main neglected tropical diseases. Although various routes of transmission sre recognized, the risk for transmission of the infection through breast-feeding has not clearly been established. We reviewed the literature on transmission of T. cruzi through breast-feeding to provide breast-feeding mothers with Chagas disease with medical guidance. Although data from animal studies and human studies are scarce, we do not recommend that mothers with Chagas disease discontinue breast-feeding, unless they are experiencing the acute phase of the disease, reactivated disease resulting from immunosuppression, or bleeding nipples. In these cases, thermal treatment of milk before feeding the infant may be considered. PMID:24050257
Norman, Francesca F; López-Vélez, Rogelio
Chagas disease (infection by the protozoan Trypanosoma cruzi) is a major parasitic disease of the Americas and one of the main neglected tropical diseases. Although various routes of transmission sre recognized, the risk for transmission of the infection through breast-feeding has not clearly been established. We reviewed the literature on transmission of T. cruzi through breast-feeding to provide breast-feeding mothers with Chagas disease with medical guidance. Although data from animal studies and human studies are scarce, we do not recommend that mothers with Chagas disease discontinue breast-feeding, unless they are experiencing the acute phase of the disease, reactivated disease resulting from immunosuppression, or bleeding nipples. In these cases, thermal treatment of milk before feeding the infant may be considered.
Lakati, Alice; Binns, Colin; Stevenson, Mark
In the fast growing city of Nairobi, women often combine the roles of mother and worker in trying to achieve better standards of living. The objective of this study was to document the effect of returning to work on breast-feeding by mothers in Kenya. A cross-sectional survey. Outpatient clinics of two major hospitals in Nairobi, one government hospital in an economically deprived area and one high-fee private hospital. Four hundred and forty-four working mothers from low and higher socio-economic areas in Nairobi. All working mothers with infants aged 4 to 12 months attending during the survey period were invited to participate. The prevalence of breast-feeding at the time of interview was found to be 94.1%. The lower socio-economic group exhibited a higher prevalence of breast-feeding (99%), 10% greater than the higher socio-economic group. The mean number of hours the mothers were away from home due to work was 46.2 hours each week. The majority (54.4%) of the mothers employed a 'house-girl' to care for their infant while they were at work, while 28.4% were able to take their infants to work. Most of the breast-feeding mothers (95%) breast-fed their infants at least three times a day and only 23 mothers reported not being able to breast-feed their infants during the day. The lower socio-economic group had a mean of 5.09 breast-feeding times per day while the higher socio-economic group had a mean of 3 times a day. In a logistic regression analysis the mode of work (fixed working hours vs. shift working hours) was associated with exclusive breast-feeding at one month (odds ratio (OR)=0.45) and two months (OR=0.39). In Western countries 'return to work' is often cited as the reason that breast-feeding is discontinued prematurely. In this study we have shown how mothers in Kenya are able to successfully continue breast-feeding after they have returned to work, often for very long hours.
Mayer-Davis, Elizabeth J.; Rifas-Shiman, Sheryl L.; Zhou, Li; Hu, Frank B.; Colditz, Graham A.; Gillman, Matthew W.
OBJECTIVE We sought to evaluate whether maternal diabetes or weight status attenuates a previously reported beneficial effect of breast-feeding on childhood obesity. RESEARCH DESIGN AND METHODS Growing Up Today Study (GUTS) participants were offspring of women who participated in the Nurses’ Health Study II. In the present study, 15,253 girls and boys (aged 9–14 years in 1996) were included. Maternal diabetes and weight status and infant feeding were obtained by maternal self-report. We defined maternal overweight as BMI ≥25 kg/m2. Childhood obesity, from self-reported height and weight, was based on the Centers for Disease Control and Prevention definitions as normal, at risk for overweight, or overweight. Maternal status categories were nondiabetes/normal weight, nondiabetes/overweight, or diabetes. Logistic regression models used generalized estimating equations to account for nonindependence between siblings. RESULTS For all subjects combined, breast-feeding was associated with reduced overweight (compared with normal weight) in childhood. Compared with exclusive use of formula, the odds ratio (OR) for exclusive breast-feeding was 0.66 (95% CI 0.53– 0.82), adjusted for age, sex, and Tanner stage. Results did not differ according to maternal status (nondiabetes/normal weight OR 0.73 [95% CI 0.49 –1.09]; nondiabetes/overweight 0.75 [0.57– 0.99]; and diabetes 0.62 [0.24 –1.60]). Further adjustment for potential confounders attenuated results, but results remained consistent across strata of maternal status (P value for interaction was 0.50). CONCLUSIONS Breast-feeding was inversely associated with childhood obesity regardless of maternal diabetes status or weight status. These data provide support for all mothers to breast-feed their infants to reduce the risk for childhood overweight. PMID:17003298
Lessen, Rachelle; Crivelli-Kovach, Andrea
Women who desire to breast-feed their sick newborns often encounter obstacles, including insufficient support and education as well as unsupportive hospital practices. The purpose of this study was to describe maternal, neonatal, and outside influences associated with the intention, initiation, and duration of breast-feeding for women whose newborns were admitted to the neonatal intensive care unit. One hundred mothers were interviewed. Most mothers (67%) intended to breast-feed exclusively and this was significantly related to maternal characteristics such as age, education, parity, smoking and marital status, pre-breast-feeding experience, and the influences of the neonate's father and prenatal education. Seventy-eight mothers initiated pumping. Initiation was significantly related to maternal education, smoking, parity, previous breast-feeding experience, the neonate's physician, the neonate's father, and postpartum breast-feeding education. Fifty-four mothers were followed up by telephone after discharge until weaning. Thirty percent were exclusively breast-feeding at 2 weeks after discharge, and 15% were breast-feeding at 1 year. Duration of breast-feeding was significantly associated with education, marital status, ethnicity, income, assistance from nurses and lactation consultants, and feeding method along with milk type and milk volume at discharge. Increased family support, timely breast-feeding information, and a supportive neonatal intensive care unit environment are needed for women to succeed in breast-feeding their hospitalized newborns.
Singh, Pmp; Bhalwar, R
A cross sectional epidemiological study design was undertaken on a randomly selected sample of 175 families of Armed Forces personnel staying in a large cantonment and having at least one child in the age group 3 to 24 months. The mean duration of lactational amenorrhoea was found to be 6.24 months (SD ± 3.25 months) and that of breast feeding was found to be 11.14 months (SD ± 6.37 month). The present study observed positive association between the duration of exclusive breast feeding and the duration of lactational amenorrhoea, as well as between the lack of practice of exclusive breast feeding and number of spells of upper respiratory tract infection and acute gastroenteritis. Based on the findings of the study, certain measures to promote the practice of exclusive breast feeding for the first 4-6 months of life have been suggested.
Sabanayagam, Charumathi; Shankar, Anoop; Chong, Yap-Seng; Wong, Tien Yin; Saw, Seang Mei
Studies from developed Western countries have shown inconsistent associations between breast-feeding and overweight/obesity in children and adolescents. Few data are available from Asian populations. The purpose of the present study was therefore to evaluate the association between breast-feeding and overweight/obesity in a study of 10-12-year-old children in Singapore. A total of 797 school children (49% girls, 76% Chinese) who participated in the Singapore Cohort Study of the Risk Factors for Myopia (SCORM) were examined. Overweight/obesity (n = 179) was defined as age-sex-specific body mass index (BMI) cut-offs corresponding to BMI of 25 kg/m(2) for overweight and 30 kg/m(2) for obesity at age 18 based on the International Obesity Task Force (IOTF) reference. The prevalence of overweight/obesity was 22.5%. Overall, breast-feeding was not found to be associated with overweight/obesity. After adjusting for potential confounders, the multivariable odds ratio (95% confidence interval) of overweight/obesity was 1.14 (0.80-1.63) for ever breast-fed compared with never breast-fed, 1.00 (0.57-1.72) for breast-fed for >3 months compared to < or =3 months and 0.79 (0.47-1.34) for exclusive/mostly breast-fed compared to partly breast-fed. No significant associations were detected among breast-feeding, its type, and duration with overweight/obesity in this Asian cohort of 10-12-year-old children.
Mullany, Luke C; Katz, Joanne; Li, Yue M; Khatry, Subarna K; LeClerq, Steven C; Darmstadt, Gary L; Tielsch, James M
Initiation of breast-feeding within 1 h after birth has been associated with reduced neonatal mortality in a rural Ghanaian population. In South Asia, however, breast-feeding patterns and low birth weight rates differ and this relationship has not been quantified. Data were collected during a community-based randomized trial of the impact of topical chlorhexidine antisepsis interventions on neonatal mortality and morbidity in southern Nepal. In-home visits were conducted on d 1-4, 6, 8, 10, 12, 14, 21, and 28 to collect longitudinal information on timing of initiation and pattern of breast-feeding. Multivariable regression modeling was used to estimate the association between death and breast-feeding initiation time. Analysis was based on 22,838 breast-fed newborns surviving to 48 h. Within 1 h of birth, 3.4% of infants were breast-fed and 56.6% were breast-fed within 24 h of birth. Partially breast-fed infants (72.6%) were at higher mortality risk [relative risk (RR) = 1.77; 95% CI = 1.32-2.39] than those exclusively breast-fed. There was a trend (P = 0.03) toward higher mortality with increasing delay in breast-feeding initiation. Mortality was higher among late (> or = 24 h) compared with early (< 24 h) initiators (RR = 1.41; 95% CI = 1.08-1.86) after adjustment for low birth weight, preterm birth, and other covariates. Improvements in breast-feeding practices in this setting may reduce neonatal mortality substantially. Approximately 7.7 and 19.1% of all neonatal deaths may be avoided with universal initiation of breast-feeding within the first day or hour of life, respectively. Community-based breast-feeding promotion programs should remain a priority, with renewed emphasis on early initiation in addition to exclusiveness and duration of breast-feeding.
Aksoy, Adnan; Ozdemir, Murat; Aslan, Lokman; Aslankurt, Murat; Gul, Ozlem
To evaluate the effect of human milk on ocular morbidity in infants who did not breast feed during the first 6 months of life. This retrospective randomized study included 154 subjects who were first or second grade elementary school students, 66-84 month of age. These children were randomly selected from 2080 students during health screenings. All of them were born at term and were normal birth weight. The study was composed of 3 age- and sex-matched groups. Group 1 included 52 subjects who had never been breast fed. Group 2 included 42 subjects who were breast fed and also received additional food (infant formula). Group 3 included 60 subjects who were only breast fed until 6 months old (no formula) except for the first month of life. All subjects underwent a complete ophthalmic examination and any morbidity was recorded. Frequencies of ocular morbidity were compared among the groups by using the chi-squared test. We found significant refractive errors in 12 (23%) subjects in Group 1 (no breast feeding). There was no significant refractive error in Group 2 (breast feeding and formula) and Group 3 (breast feeding only). The difference among the groups was statistically significant (p=0.014, chi-squared test). Allergic conjunctivitis was found in 5 subjects in Group 1, 3 in Group 2, and 2 in Group 3. There was no significant difference among the groups (p=0.395). Refractive errors were more frequent in Group 1 (no breast feeding) than in Group 2 (breast feeding and formula) or Group 3 (breast feeding only). There is a need to confirm this finding by performing studies with larger sample sizes.
... Lifestyle Infant and toddler health Curious about extended breast-feeding? Know the benefits, the role breast milk plays ... baby beyond age 1 — also known as extended breast-feeding — you might have questions about the process. Get ...
Brew, Bronwyn K; Allen, C Wendy; Toelle, Brett G; Marks, Guy B
There is conflicting evidence concerning the relationship between breast feeding and wheezing illness. The objective of this study was to investigate whether there is any association between breast feeding and wheezing in children aged over 5 years and to discover possible sources of heterogeneity. An electronic search of MEDLINE and EMBASE databases was conducted from January 2000 to June 2010. In addition, reference lists from relevant publications were searched. Birth cohort, cross-sectional and case-control studies were included if they measured any breast feeding or exclusive breast feeding for 3 or 4 months. Wheezing illness, including asthma, was identified based on symptoms, reported diagnosis or objective criteria. Thirty-one publications were identified for meta-analysis. There was no association found between any or exclusive breast feeding and wheezing illness, although there was a high level of heterogeneity between the studies. Subgroup analysis revealed that any breast feeding slightly lowers the odds of wheeze (pooled odds ratio 0.92 [0.86, 0.98]) but slightly increases the odds of asthma defined by specific criteria (pooled odds ratio 1.10 [1.00, 1.22]). This meta-analysis does not provide evidence that breast feeding is protective against wheezing illness in children aged 5 years and over. The difference in the effects of breast feeding according to the nature of the wheezing illness highlights the importance of the heterogeneity of illness phenotypes. © 2011 Blackwell Publishing Ltd.
Chen, Beatrice A; Reeves, Matthew F; Creinin, Mitchell D; Schwarz, E Bimla
The objective of this study was to assess the effect of timing of postpartum levonorgestrel-releasing intrauterine device (IUD) insertion on breast-feeding continuation. Women interested in using a levonorgestrel IUD postpartum were randomized to immediate postplacental insertion (postplacental group) or insertion 6-8 weeks after vaginal delivery (delayed group). Duration and exclusivity of breast-feeding were assessed at 6-8 weeks, 3 months, and 6 months postpartum. Only women who received an IUD were included in this analysis. Breast-feeding was initiated by 32 (64%) of 50 of women receiving a postplacental IUD and 27 (58.7%) of 46 of women receiving a delayed IUD (p=.59). More women in the delayed group compared with the postplacental group continued to breast-feed at 6-8 weeks (16/46 vs. 15/50, p=.62), 3 months (13/46 vs. 7/50, p=.13), and 6 months postpartum (11/46 vs. 3/50, p=.02). The results did not differ when only women who initiated breast-feeding or only primiparous women with no prior breast-feeding experience were analyzed. Immediate postplacental insertion of the levonorgestrel IUD is associated with shorter duration of breast-feeding and less exclusive breast-feeding. Further studies on the effects of early initiation of progestin-only methods on women's lactation experience are needed. Copyright © 2011 Elsevier Inc. All rights reserved.
Victora, Cesar G; Horta, Bernardo L; Post, Paulo; Lima, Rosângela C; De Leon Elizalde, Jacqueline W; Gerson, Branca Maria Cerezer; Barros, Fernando C
Objective To assess the association between breast feeding and blood lipid levels in adolescence. Design Population based prospective birth cohort study. Setting City of Pelotas, Brazil. Subjects All hospital births taking place in 1982; 79% of all males (n = 2250) were followed up for 18 years, and 2089 blood samples were available. Interventions None. Main outcome measures Total cholesterol and fractions (very low density lipoprotein cholesterol (VLDL), low density lipoprotein cholesterol (LDL), high density lipoprotein cholesterol (HDL)), LDL/HDL ratio, serum triglycerides. Results Three breast feeding variables were studied: total duration of breast feeding, duration of exclusive or predominant breast feeding, and ever compared with never breast fed. Adjusted analyses were controlled for family income, household assets index, maternal education, maternal pre‐pregnancy body mass index (BMI), skin colour, birth weight, gestational age, maternal smoking during pregnancy, and adolescent BMI, and behavioural variables (fat content of diet, physical activity, smoking, and alcohol drinking). Only one association reached borderline significance (p = 0.05): LDL cholesterol was slightly higher among never (mean 41.0 mg/dl; 95% CI 39.4 to 42.7) than among ever breast fed men (38.6 mg/dl; 95% CI 38.6 to 40.3), in the adjusted analyses. All other associations were not significant (p⩾0.09). There was no evidence of effect modification according to preterm status, intrauterine growth retardation, socioeconomic level, growth velocity in the first two years of life, or nutritional status at 2 years of age. Conclusions There was no clear association between breast feeding duration and serum lipid concentrations at the age of 18 years in this sample of Brazilian men. PMID:16790835
Victora, Cesar G; Horta, Bernardo L; Post, Paulo; Lima, Rosângela C; De Leon Elizalde, Jacqueline W; Gerson, Branca Maria Cerezer; Barros, Fernando C
To assess the association between breast feeding and blood lipid levels in adolescence. Population based prospective birth cohort study. City of Pelotas, Brazil. All hospital births taking place in 1982; 79% of all males (n = 2250) were followed up for 18 years, and 2089 blood samples were available. None. Total cholesterol and fractions (very low density lipoprotein cholesterol (VLDL), low density lipoprotein cholesterol (LDL), high density lipoprotein cholesterol (HDL)), LDL/HDL ratio, serum triglycerides. Three breast feeding variables were studied: total duration of breast feeding, duration of exclusive or predominant breast feeding, and ever compared with never breast fed. Adjusted analyses were controlled for family income, household assets index, maternal education, maternal pre-pregnancy body mass index (BMI), skin colour, birth weight, gestational age, maternal smoking during pregnancy, and adolescent BMI, and behavioural variables (fat content of diet, physical activity, smoking, and alcohol drinking). Only one association reached borderline significance (p = 0.05): LDL cholesterol was slightly higher among never (mean 41.0 mg/dl; 95% CI 39.4 to 42.7) than among ever breast fed men (38.6 mg/dl; 95% CI 38.6 to 40.3), in the adjusted analyses. All other associations were not significant (p> or =0.09). There was no evidence of effect modification according to preterm status, intrauterine growth retardation, socioeconomic level, growth velocity in the first two years of life, or nutritional status at 2 years of age. There was no clear association between breast feeding duration and serum lipid concentrations at the age of 18 years in this sample of Brazilian men.
Goldfield, Eugene C; Richardson, Michael J; Lee, Kimberly G; Margetts, Stacey
This prospective study compared the coordination of sucking, swallowing, and breathing and its relationship to oxygen saturation in infants during breast-feeding and bottle-feeding. After 4 to 6 wk of exclusive breast-feeding, infants began bottle-feedings of expressed human milk using one of two systems: a soft-walled bottle and nipple (system 1, Playtex) or a hard-walled bottle and nipple (system 2, Avent). Infants' sucking, swallowing, breathing, and oxygenation were measured during breast-feeding and bottle-feeding, and coordination of these activities during breast-feeding and bottle-feeding were compared. During breast-feeding, swallowing occurred nonrandomly between breaths and did not interfere with breathing. The same distribution of swallowing occurred in infants fed with system 1, while swallowing occurred randomly in infants fed with system 2. Swallowing significantly increased during bottle-feeding among infants using system 2, but decreased among infants using system 1. Infants using system 2 also had a greater instability in the coordination of sucking, swallowing, and breathing and more perturbation of breathing. Oxygen saturation was significantly higher in infants fed with system 1 compared with system 2. These results suggest that the overall feeding pattern and oxygenation of system 1 are closer to the physiologic norm than system 2.
Bamisaiye, A; Oyediran, M A
The importance of breast-feeding to the health of infant and mother is discussed. However the working conditions of employed women in developing countries prevent exclusive breast-feeding once the mother has returned to work after delivery and also present obstacles to partial breast-feeding. The breast-feeding practices of women employed at a major health institution in Lagos, Nigeria are examined. Duration of breast-feeding was in inverse relation to salary level. Women on the lowest salaries had a mean duration of breast-feeding their last child of 8 months, whereas women in senior professional positions had a mean breast-feeding duration of 3.3 months. Conflicts with work responsibilities were the most commonly cited reason for terminating breast-feeding earlier than the mother desired. If a creche was available at place of work, half the women surveyed said they would breast-feed for longer. Anticipated durations, if a creche was available, would lengthen breast-feeding to 12 months for lowest paid women and to nearly 9 months for women at the higher salary levels. Present options available to the employed women who wishes to breast-feed as long as possible, namely the use of wet-nurses and expression of breast-milk, are discussed. It is concluded that the most satisfactory means of promoting breast-feeding among employed women is the provision of paid leave post delivery for at least three months and the provision of a creche at place of work. The costs should be borne by the employer, assisted by government in the form of grants and tax-relief.(ABSTRACT TRUNCATED AT 250 WORDS)
Henderson, Lesley; Kitzinger, Jenny; Green, Josephine
Objective To examine how breast feeding and bottle feeding are represented by the British media. Design Content analysis. Subjects Television programmes and newspaper articles that made reference to infant feeding during March 1999. Setting UK mass media. Main outcome measures Visual and verbal references to breast or bottle feeding in newspapers and television programmes. Results Overall, 235 references to infant feeding were identified in the television sample and 38 in the newspaper sample. Bottle feeding was shown more often than breast feeding and was presented as less problematic. Bottle feeding was associated with “ordinary” families whereas breast feeding was associated with middle class or celebrity women. The health risks of formula milk and the health benefits of breast feeding were rarely mentioned. Conclusions The media rarely present positive information on breast feeding, even though this feeding practice is associated with the most health benefits. Health professionals and policy makers should be aware of patterns in media coverage and the cultural background within which women make decisions about infant feeding. PMID:11073512
Jelliffe, D B; Jelliffe, E F
Interest in breast feeding and human milk continued in the literature in 1977. A review of the various areas related to lactation which appeared in publications in 1977 is made. The biological interactions between mother and nursing infant were explored. The biochemical composition of human milk was investigated in different circumstances. There seem to be particular problems with assessing the volume of breast milk produced in relation to optimal infant growth. Research as already shown that human milk has antiviral properties. Environmental pollutants are found in breast milk, but no immediate ill effects have yet been noted. Breast milk has been shown to be a better protection for the infant against protein allergies and common infections. Lactation seems to protect the mothers against development of breast cancer. Investigation continues into longterm advantages for the child of breast- as opposed to bottle-feeding. National health services have become interested in promoting breast feeding in many developing countries. Research is continuing into ways to promote breast feeding among working women.
Durmuş, Büşra; van Rossem, Lenie; Duijts, Liesbeth; Arends, Lidia R; Raat, Hein; Moll, Henriëtte A; Hofman, Albert; Steegers, Eric A P; Jaddoe, Vincent W V
Breast-feeding has been suggested to be associated with lower risks of obesity in older children and adults. We assessed whether the duration and exclusiveness of breast-feeding are associated with early postnatal growth rates and the risks of overweight and obesity in preschool children. The present study was embedded in a population-based prospective cohort study from early fetal life onwards, among 5047 children and their mothers in The Netherlands. Compared with children who were breast-fed, those who were never breast-fed had a lower weight at birth (difference 134 (95 % CI - 190, - 77) g). No associations between breast-feeding duration and exclusivity with growth rates before the age of 3 months were observed. Shorter breast-feeding duration was associated with an increased gain in age- and sex-adjusted standard deviation scores for length, weight and BMI (P for trend < 0·05) between 3 and 6 months of age. Similar tendencies were observed for the associations of breast-feeding exclusivity with change in length, weight and BMI. Breast-feeding duration and exclusivity were not consistently associated with the risks of overweight and obesity at the ages of 1, 2 and 3 years. In conclusion, shorter breast-feeding duration and exclusivity during the first 6 months tended to be associated with increased growth rates for length, weight and BMI between the age of 3 and 6 months but not with the risks of overweight and obesity until the age of 3 years.
Borkowska, Anna; Plata-Nazar, Katarzyna; Łuczak, Grazyna; Matheisel, Agnieszka
Vitamin B12 deficiency is a rare condition in children. The most frequent cause is vegetarian diet. In infants it can happen in breast fed children whose mother is on this diet. The clinical feature of the disease presents with megaloblastic anemia and symptoms such as: weakness, refusing to eat, hypotonia, paraesthesia, delayed or regressed development. We present a case report of vitamin B12 deficiency in a one-year-old, exclusively breast fed child. The mother's diet during pregnancy and breast-feeding were normal. The quality of the mother's diet and her haematological status during pregnancy and breast-feeding should be carefully monitored. It is necessary to introduce a variety of foods to expand the infant's diet at the proper time. The diagnosis of anaemia in the mother and/or in the child requires a careful investigation.
Savino, F; Bermond, S; Bonfante, G; Gallo, E; Oggero, R
The relation between mother's diet and breastmilk composition is still an open issue. Nutritional inadequacies during lactation may affect the well-being of both the mother and the infant. For this reason breast feeding women usually pay attention about their alimentary practices and about their style of life during breast-feeding period. This research was conducted to verify the adequacy of lactating mother's diet in comparison with the Italian recommended daily assumption levels of nutrients (LARN 1996) for this category. We have also compared food intake of not breast feeding mothers with the LARN, and analyzed the differences between these groups of mothers. Forty-eight healthy infants were selected, 23 bottle fed, 25 breast fed. Mothers's diet in the previous 48 hours was investigated using a structured questionnaire. The data collected were processed using software Dietosystem to obtain the daily nutrient intakes. The wetnurses's diet in comparison with the LARN 1996 resulted hypocaloric and hyperproteic, deficient in Calcium, Iron, folic acid and vitamin E. Surprisingly not breast feeding mothers's intake of nutrients is closer to LARN levels than that of breast feeding mothers. Mothers are not informed enough about their alimentation during lactating period. Pediatricians must improve their knowledge about this subject and give the mothers the information they need to achieve the recommended food requirements.
Santorelli, Gillian; Petherick, Emily; Waiblinger, Dagmar; Cabieses, Baltica; Fairley, Lesley
Initiation of breast feeding and duration of any breast feeding are known to differ by ethnic group, but there are limited data on differences in exclusive breast feeding. This study aimed to determine if there are ethnic differences in the initiation and duration of any and exclusive breast feeding. Breast-feeding data were obtained from a subsample of 1365 women recruited to a multi-ethnic cohort study (Born in Bradford) between August 2008 and March 2009. Poisson regression was used to investigate the impact of socio-economic, life style and birth factors on ethnic differences in the prevalence of breast feeding. Compared with white British mothers, initiation of breast feeding was significantly higher in all ethnic groups and this persisted after adjustment for socio-economic, life style and birth factors [Pakistani: prevalence rate ratio (PRR) = 1.19 (95% confidence interval 1.10, 1.29); Other South Asian: PRR = 1.29 (1.18, 1.42); Other ethnicities: PRR = 1.33 (1.21, 1.46)]. There were no differences in exclusive breast feeding at 4 months [Pakistani: PRR = 0.77 (0.54, 1.09); Other South Asian: PRR = 1.55 (0.99, 2.43); Other ethnicities: PRR = 1.50 (0.88, 2.56)]. Any breast feeding at 4 months was significantly higher in mothers of all non-white British ethnicities [Pakistani: PRR = 1.27 (1.02, 1.58); Other South Asian: PRR = 1.99 (1.52, 2.62); Other ethnicities: 2.45 (1.86, 3.21)]. Whilst women of ethnic minority groups were significantly more likely to initiate breast feeding and continue any breast feeding for 4 months compared with white British women, the rates of exclusive breast feeding at 4 months were not significantly different once socio-economic, life style and birth factors were accounted for. © 2013 John Wiley & Sons Ltd.
Montgomery, S M; Ehlin, A; Sacker, A
Some early life exposures may result in a well controlled stress response, which can reduce stress related anxiety. Breast feeding may be a marker of some relevant exposures. To assess whether breast feeding is associated with modification of the relation between parental divorce and anxiety. Observational study using longitudinal birth cohort data. Linear regression was used to assess whether breast feeding modifies the association of parental divorce/separation with anxiety using stratification and interaction testing. Data were obtained from the 1970 British Cohort Study, which is following the lives of those born in one week in 1970 and living in Great Britain. This study uses information collected at birth and at ages 5 and 10 years for 8958 subjects. Class teachers answered a question on anxiety among 10 year olds using an analogue scale (range 0-50) that was log transformed to minimise skewness. Among 5672 non-breast fed subjects, parental divorce/separation was associated with a statistically significantly raised risk of anxiety, with a regression coefficient (95% CI) of 9.4 (6.1 to 12.8). Among the breast fed group this association was much lower: 2.2 (-2.6 to 7.0). Interaction testing confirmed statistically significant effect modification by breast feeding, independent of simultaneous adjustment for multiple potential confounding factors, producing an interaction coefficient of -7.0 (-12.8 to -1.2), indicating a 7% reduction in anxiety after adjustment. Breast feeding is associated with resilience against the psychosocial stress linked with parental divorce/separation. This could be because breast feeding is a marker of exposures related to maternal characteristics and parent-child interaction.
Friedman, Noah J; Zeiger, Robert S
Breast-feeding is the preferred method of infant nutrition for numerous reasons. However, its role in the prevention of allergic disease remains controversial. Reasons for this controversy include methodological differences and flaws in the studies performed to date, the immunologic complexity of breast milk itself and, possibly, genetic differences among patients that would affect whether breast-feeding is protective against the development of allergies or is in fact sensitizing. The preponderance of evidence does suggest, however, that there would be much to lose by not recommending breast-feeding. In general, studies reveal that infants fed formulas of intact cow's milk or soy protein compared with breast milk have a higher incidence of atopic dermatitis and wheezing illnesses in early childhood. Consistent with these findings, exclusive breast-feeding should be encouraged for at least 4 to 6 months in infants at both high and low risk of atopy and irrespective of a history of maternal asthma.
Kranke, Peter; Frambach, Torsten; Schelling, Philip; Wirbelauer, Johannes; Schaefer, Christof; Stamer, Ulrike
Until a few years ago an interruption of breast-feeding for 12 or even 24 hours was recommended for breast-feeding mothers after anaesthesia, this is no longer valid. If it is the mother's wish, if she is sufficiently awake and physically able, there is no reason not to start breast-feeding a mature and healthy baby immediately after recovery from a general or regional anaesthesia. Even breast-feeding after a Caesarean delivery with administration of the common anaesthetics in the usual (single) doses is no longer considered to be a problem since the amount of the substance taken up from colostrum is vanishingly small in comparison to the amount that is transferred by transplacental routes. Neither the pharmacological properties of the drugs used in association with anaesthesia nor clinical experience justify an interruption of breast-feeding.
Farland, Leslie V; Eliassen, A Heather; Tamimi, Rulla M; Spiegelman, Donna; Michels, Karin B; Missmer, Stacey A
Objective To investigate the association between lifetime breast feeding, exclusive breast feeding, postpartum amenorrhea, and incidence of endometriosis among parous women.Design Prospective cohort study.Setting Nurses' Health Study II, 1989-2011.Participants 72 394women who reported having one or more pregnancies that lasted at least six months, 3296 of whom had laparoscopically confirmed endometriosis. For each pregnancy, women reported duration of total breast feeding, exclusive breast feeding, and postpartum amenorrhea. Main outcome measures Incident self reported laparoscopically confirmed endometriosis (96% concordance with medical record) in parous women. Multivariable Cox proportional hazard models were used to calculate hazard ratios and 95% confidence intervals for diagnosis of endometriosis.Results Duration of total and exclusive breast feeding was significantly associated with decreased risk of endometriosis. Among women who reported a lifetime total length of breast feeding of less than one month, there were 453 endometriosis cases/100 000 person years compared with 184 cases/100 000 person years in women who reported a lifetime total of ≥36 months of breast feeding. For every additional three months of total breast feeding per pregnancy, women experienced an 8% lower risk of endometriosis (hazard ratio 0.92, 95% confidence interval 0.90 to 0.94; P<0.001 for trend) and a 14% lower risk for every additional three months of exclusive breast feeding per pregnancy (0.86, 0.81 to 0.90; P<0.001 for trend). Women who breastfed for ≥36 months in total across their reproductive lifetime had a 40% reduced risk of endometriosis compared with women who never breast fed (0.60, 0.50 to 0.72). The protective association with breast feeding was strongest among women who gave birth within the past five years (P=0.04 for interaction). The association with total breast feeding and exclusive breast feeding on endometriosis was partially influenced by
Brown, Amy; Raynor, Peter; Lee, Michelle
to examine factors associated with breast-feeding initiation and duration in young mothers (≤24 years). a retrospective questionnaire completed between six and 24 months post partum. mothers were recruited from local mother and infant groups, nurseries and online mother and infant forums. 138 mothers aged between 17 and 24 years (mean age 21.93 years) participants completed a retrospective questionnaire about their experience of breast or artificial milk feeding during the first six months post partum. A further 10 mothers who breast fed for at least six months completed a semi-structured interview. Breast feeding for at least six months was positively associated with attending a breast-feeding support group, believing breast feeding to be easy, being part of an environment where breast feeding is normative, and being encouraged to breast feed by others. themes raised highlight the importance of viewing breast feeding as the normal way to feed an infant and having others support the mother in this behaviour. increasing breast-feeding initiation and duration among this at-risk group is important for both infant and maternal health. Helping mothers to view breast feeding as the norm, creating an environment where breast feeding is accepted, providing professional and peer support, and encouraging the mother to continue breast feeding are important steps in raising breast-feeding rates among younger mothers. Copyright © 2009 Elsevier Ltd. All rights reserved.
Karall, Daniela; Ndayisaba, Jean-Pierre; Heichlinger, Angelika; Kiechl-Kohlendorfer, Ursula; Stojakovic, Sarah; Leitner, Hermann; Scholl-Bürgi, Sabine
Breast-feeding is the recommended form of nutrition for the first 6 months. This target is unmet, however, in most industrialized regions. We evaluated aspects of breast-feeding in a cohort of mother-baby dyads. Breast-feeding practices in 555 mother-baby dyads were prospectively studied for 24 months (personal interview at birth and 7 structured telephone interviews). Of the babies, 71.3% were fully breast-fed on discharge from maternity hospitals and 11.9% were partially breast-feed. Median breast-feeding duration was 6.93 (interquartile range 2.57-11.00) months; for full (exclusive) breast-feeding 5.62 (interquartile range 3.12-7.77) months; 61.7% received supplemental feedings during the first days of life. Breast-feeding duration in babies receiving supplemental feedings was significantly shorter (median 5.06 months versus 8.21 months, P < 0.001). At 6 months, 9.4% of the mothers were exclusively and 39.5% partially breast-feeding. Risk factors for early weaning were early supplemental feedings (odds ratio [OR] 2.87, 95% CI 1.65-4.98), perceived milk insufficiency (OR 7.35, 95% CI 3.59-15.07), low breast-feeding self-efficacy (a mother's self-confidence in her ability to adequately feed her baby) (OR 3.42, 95% CI 1.48-7.94), lower maternal age (OR 3.89, 95% CI 1.45-10.46), and lower education level of the mother (OR 7.30, 95% CI 2.93-18.20). The recommended full breast-feeding duration of the first 6 months of life was not reached. Sociodemographic variables and factors directly related to breast-feeding practices play an important role on breast-feeding duration/weaning in our region. Understanding risk factors will provide insights to give better support to mothers and prevent short- and long-term morbidity following early weaning.
Shah, Dheeraj; Singh, Meenakshi; Gupta, Piyush; Faridi, M M A
The aim of the present study was to evaluate whether the order of complementary feeding in relation to breast-feeding affects breast milk, semisolid, or total energy intake in infants. The present study was designed as a randomized crossover trial. The study was conducted in a tertiary care hospital. The study participants were 25 healthy infants between the ages of 7 and 11 months who were exclusively breast-fed for at least 6 months and were now receiving complementary foods for at least 1 month in addition to breast-feeding. Infants were randomized to follow a sequence of either complementary feeding before breast-feeding (sequence A) or complementary feeding after breast-feeding (sequence B) for the first day (24 hours) of the study period using simple randomization. For the next day, the sequence was reversed for each child. All babies received 3 actively fed complementary food meals per day (morning, afternoon, and evening). A semisolid study diet was prepared in the hospital by cooking rice and pulse with oil using a standard method, ensuring the energy density of at least 0.6 kcal/g. The infants were allowed ad libitum breast-feeding during the observation period. Semisolid intake was directly measured and breast milk intake was quantified by test weighing method. Energy intake from complementary foods was calculated from the product of energy density of the diet served on that day and the total amount consumed. The total energy intake and energy intake from breast milk and complementary foods between the 2 sequences were compared. The mean (standard deviation) energy intake from breast milk during 12 hours of daytime by following sequence A (complementary feeding before breast-feeding) was 132.0 (67.4) kcal in comparison with 135.9 (56.2) kcal in sequence B, which was not statistically different (P = 0.83). The mean (standard deviation) energy consumed from semisolids in sequences A and B was also comparable (88.6 [75.5] kcal vs. 85.5 [89.7] kcal; P
Monteiro, C A; Zũniga, H P; Benicio, M H; Rea, M F; Tudisco, E S; Sigulem, D M
A random sampling of children under age five in Sao Paulo, Brazil, 1984/85, disclosed the median duration of breast-feeding to be 3.5 months and the duration of exclusive breast-feeding, 2.0 months. A comparison of these figures with those of a similar survey carried out in the same city in 1973/74 revealed a substantial increase in both the frequency and duration of breast-feeding. The trend was evident in all socioeconomic strata but most marked among women from higher income and educational levels. PMID:3605475
Yokoyama, Yoshie; Murai, Chikako; Miyashita, Akane; Tatsumi, Tomomi; Fujioka, Hiroki
This study aimed to identify the breast-feeding rate and associated factors and to get better understanding on the mother's sentiment towards child rearing due to differences in feeding methods. This information can be used as primary sources providing effective support through community-based health care for mothers and infants. The study was carried out in Osaka city from April 2005 to December 2009. Data from the health-checkup records on infants aged 3-5 months were used after excluding any personal information. The data used included feeding methods (exclusive breast-feeding, mixed-feeding, and bottlefeeding), gestational age, multiple pregnancy status, gender, birth weight, use of an incubator, and birth year. Moreover, the data included the following maternal factors: planned or unplanned nature of pregnancy, smoking and drinking status during pregnancy, presence or absence of pregnancy-induced hypertension, maternal age at delivery, working status, presence or absence of financial anxiety, presence or absence of child-rearing support, presence or absence of individuals who can provide advice concerning child rearing, and sentiments of mothers during child rearing. From April 2005 to December 2009, 2552 infants underwent health checkups designed for infants. Of these, data on 2476 children, excluding 61 infants with unknown feeding methods and 15 infants aged 6 months, were used for analyses. The results showed that 56.6%, 28.7%, and 14.7% of children received exclusive breast-feeding, mixed-feeding, and bottle-feeding, respectively. Infant feeding methods were significantly associated with the birth year: in recent years, a decrease in the number of mothers who chose to bottle-feed their infants was observed. Furthermore, the feeding methods were associated with multiple births, birth weight, maternal smoking status during pregnancy, and maternal age at delivery. The results revealed that mothers who chose to breast-feed exclusively enjoyed child rearing at
Reisinger, Kostan W; de Vaan, Loes; Kramer, Boris W; Wolfs, Tim G A M; van Heurn, L W Ernest; Derikx, Joep P M
The incidence of necrotizing enterocolitis (NEC) is higher in formula-fed babies than in breast-fed babies, which may be caused by breast-feeding-induced gut maturation. The effect of breast-feeding on gut maturation has been widely studied in animal models. This study aimed to assess the effects of breast-feeding on intestinal maturation in prematurely born babies by evaluating postnatal changes in urinary intestinal fatty acid binding protein (I-FABP) levels, a specific enterocyte marker. Gut maturation in 40 premature babies (<37 weeks of gestation) without gastrointestinal morbidity was studied, of whom 21 were exclusively breast-fed and 19 were formula-fed infants. Urinary I-FABP levels as the measure of gut maturation were measured at 5, 12, 19, and 26 days after birth. In breast-fed infants, there was a significant increase in median urinary I-FABP levels between 5 and 12 days after birth (104 [78-340] pg/mL to 408 [173-1028] pg/mL, P = 0.002), whereas I-FABP concentration in formula-fed infants increased between 12 and 19 days after birth (105 [44-557] pg/mL, 723 [103-1670] pg/mL, P = 0.004). Breast-fed babies had significantly higher median urinary I-FABP levels at postnatal day 12 (P = 0.01). The time course of the postnatal increase in urinary I-FABP levels reflecting gut maturation was significantly delayed in formula-fed babies, suggesting a delayed physiological response in formula-fed compared with breast-fed infants.
Peralta, O; Díaz, S; Croxatto, H
New mothers who do not breastfeed can choose any contraceptive method that would otherwise be suitable. Hormonal and barrier methods may be used in the immediate postpartum but IUDs should not be inserted until the later postpartum. Women who breastfeed require a contraceptive method that will not interfere with lactation or with the infant's growth and development. Although lactation itself provides a period of reduced fertility that is important in spacing births, great individual variability and lack of predictability about its duration means that women desiring maximum protection should begin contraception during lactation. The beginning of supplemental feeding and the return of menstruation are signs of increased fertility. It is difficult for methodological reasons to evaluate the effects of different contraceptive methods on lactation, which depends on many other variables as well. Many studies have failed to control other variables adequately, have used very small samples, or have failed to establish at what moment contraception is begun. There has been little uniformity in defining the duration or intensity of lactation. Available work however indicates that IUDs have no effect on lactation or infant growth. IUDs inserted in the early postpartum may be expelled or cause perforation. Barrier methods have never been carefully evaluated but theoretically they should not affect lactation. Methods based on periodic abstinence have no negative effects on lactation. The majority of studies on combined oral contraceptives (OCs) demonstrate negative influences on lactation, infant growth, and the composition of the milk, with effects apparently related to the dose and timing of the beginning of treatment. Combined OCs are contraindicated during lactation. If the woman wishes to use hormonal methods, the choice should be limited to those without estrogen and with minimal progestin doses so that the smallest possible steroid dose is passed to the infant. Low
Azim, Hatem A; Bellettini, Giulia; Gelber, Shari; Peccatori, Fedro A
Breast cancer is the most common malignant tumor-affecting women during the child bearing period. With the rising trend in delaying pregnancy later in life, the issue of subsequent pregnancy and lactation following breast cancer diagnosis has been more frequently encountered. In this context, data is scarce particularly those addressing the issue of lactation. In this review, we discussed different endocrinal, clinical and biological aspects dealing with breast-feeding after breast cancer in an attempt to determine how safe and feasible this approach is.
Tawiah-Agyemang, C; Kirkwood, B R; Edmond, K; Bazzano, A; Hill, Z
To explore why women in Ghana initiate breast-feeding early or late, who gives advice about initiation and what foods or fluids are given to babies when breast-feeding initiation is late. Qualitative data were collected through 52 semistructured interviews with recent mothers, 8 focus group discussions with women of child-bearing age and 13 semistructured interviews with health workers, policy makers and implementers. The major reasons for delaying initiation of breast-feeding were the perception of a lack of breast milk, performing postbirth activities such as bathing, perception that the mother and the baby need rest after birth and the baby not crying for milk. Facilitating factors for early initiation included delivery in a health facility, where the staff encouraged early breast-feeding, and the belief in some ethnic groups that putting the baby to the breast encourages the milk. Policy makers tended to focus on exclusive breast-feeding rather than early initiation. Most activities for the promotion of early initiation of breast-feeding were focused on health facilities with very few community activities. It is important to raise awareness about early initiation of breast-feeding in communities and in the policy arena. Interventions should focus on addressing barriers to early initiation and should include a community component.
Schultz, Megan L; Kostic, Mark; Kharasch, Sigmund
Opiates are frequently prescribed postpartum for pain relief after cesarean delivery, episiotomies, and headaches. It is estimated that greater than 30% of breast-feeding mothers in the United States are prescribed opiates for pain relief associated with childbirth. Many opiates are readily transferred to human milk, although life-threatening events are rare. We report a 6-day-old breast-feeding infant whose mother was taking hydromorphone for pain relief from a cesarean delivery and whose clinical course was suggestive of opiate toxicity. This case emphasizes the importance of thorough medication history taking in postpartum breast-feeding mothers whose infants may present with symptoms of opiate toxicity. Semisynthetic opiates are frequently not detected on emergency department urine toxicology screens. The pertinent literature is reviewed.
Oheneba-Sakyi, Y; Takyi, B K
This study utilizes data from the Ghana Fertility Survey (GFS) (1979-1980) to investigate breast feeding in Ghana and the factors that affect it. Using life table procedures, we found evidence that, when other factors are held constant, older cohorts, women with no schooling, those who work in the agricultural sector, those affiliated with traditional Ghanaian religions, Mole-Dagbanis, rural residents, residents of the Volta, Brong-Ahafo, northern, and upper regions, and low-parity women show longer durations of breast feeding. It is recommended that, along with other fertility reduction measures, prolonged breast feeding among all Ghanaian mothers should be encouraged to help reduce conception and to ensure healthy children.
Kull, Inger; Almqvist, Catarina; Lilja, Gunnar; Pershagen, Göran; Wickman, Magnus
The evidence for a preventive effect of breast-feeding on asthma and other allergic diseases in childhood is inconclusive. The aim of this study was to investigate the effect of breast-feeding on asthma and sensitization to airborne allergens among children up to 4 years of age. A birth cohort of 4089 children was followed. Exposure data were collected at 2 months and 1 year of age. The total dose of breast milk was estimated by combining periods of exclusive and partial breast-feeding. Outcomes data were collected at 1, 2, and 4 years of age. The response rate at 4 years was 90%, and 73% participated in a clinical investigation, including blood sampling for analysis of specific IgE and lung function testing. Children with onset of wheeze during lactation (n=217) were excluded in some of the analyses to avoid disease-related modification of exposure. Exclusive breast-feeding for 4 months or more reduced the risk of asthma at the age of 4 years (odds ratio [OR], 0.72; 95% CI, 0.53-0.97), irrespective of sensitization to common airborne allergens ( P=.72). Excluding children with wheeze during lactation tended to strengthen the risk estimate (OR, 0.64; 95% CI, 0.46-0.88). A duration of 3 months or more of partial breast-feeding seemed to offer additional protection; exclusive breast-feeding for 3 to 4 months combined with partial breast-feeding for 3 months or more resulted in an OR of 0.44 (95% CI, 0.21-0.87). The effects tended to be stronger in children without heredity for allergy ( P interaction=.36). Breast-feeding reduces the risk of asthma during the first 4 years of life.
Matheson, Melanie Claire; Erbas, Bircan; Balasuriya, Aindralal; Jenkins, Mark Andrew; Wharton, Cathryn Leisa; Tang, Mimi Lai-Kuan; Abramson, Michael John; Walters, Eugene Haydn; Hopper, John Llewelyn; Dharmage, Shyamali Chandrika
The literature regarding the association between breast-feeding and atopic diseases has been contradictory. We have assessed the relationship between breast-feeding and atopic disorders in a cohort followed into middle age. The Tasmanian Asthma Study is a population-based prospective cohort study that has followed participants from the age of 7 to 44 years. Exclusive breast-feeding in the first 3 months of life was examined as a risk factor for atopic diseases by using multiple logistic regression and generalized estimating equation analyses. At age 7 years, exclusively breast-fed children with a maternal history of atopy had a marginally lesser risk of current asthma than those not exclusively breast-fed (odds ratio [OR], 0.8; 95% CI, 0.6-1.0). However, after age 7 years, the risk reversed, and exclusively breast-fed children had an increased risk of current asthma at 14 (OR, 1.46; 95% CI, 1.02-2.07), 32 (OR, 1.84; 95% CI, 1.06-3.3), and 44 (OR, 1.57; 95% CI, 1.15-2.14) years. Exclusively breast-fed children also had a reduced risk of food allergy at age 7 years but an increased risk of food allergy (OR, 1.26; 95% CI, 1.1-1.5) and allergic rhinitis (OR, 1.2; 95% CI, 1.0-1.3) at 44 years. Exclusively breast-fed babies with a maternal history of atopy were less likely to develop asthma before the age of 7 years, but more likely to develop asthma after the age of 7 years. The current recommendation to breast-feed high-risk infants for protection against early wheezing illness can be confirmed. However, the recommendation should be reconsidered for protection against allergic asthma and atopy in the longer term.
Müller, M J; Lange, M; Paul, T; Seeliger, S
The number of opiate addicted patients treated with opioid replacement therapy is continuously increasing. In Germany, 57.7% of these patients are treated with methadone and 18.6% with buprenorphine. This maintenance therapy provides several advantages while addicted pregnant women and their foetus have a high benefit from appropriate replacement therapy. However, the recommendations concerning breast feeding during an opioid replacement therapy are discussed controversially, because methadone as well as buprenorphine accumulate in breast milk. This accumulation might cause damages to the newborn's health; so, child benefits of breast feeding have to be balanced with possible health risks.This review provides an overview of a selective literature search based on the PubMed-database and german consensus recommendations. Used search terms included: (methadone*) AND (breastfeeding OR lactation), (methadone*) AND (human milk), (buprenorphine*) AND (breastfeeding OR lactation) and (buprenorphine*) AND (human milk).According to the available literature, addicted women, substinated with methadone or buprenorphine are allowed to breast feed their newborns. The advantages of breast feeding prevail the risks of an infant opiate intoxication caused by methadone or buprenorphine. © Georg Thieme Verlag KG Stuttgart · New York.
Tripathy, A K; Mishra, L; Bakhshi, Sameer; Arya, L S
Breast milk is known to have anti-infective and immunomodulating effects on infants, but its association with childhood cancer has not been well studied. Artificial feeding may affect the immune response in carcinogenesis. In this communication the authors have reviewed different articles describing the association between breast feeding (BF) and subsequent development of childhood hematological malignancy. It appears that BF may have a protective effect on childhood cancer, both the duration of BF as well as the quantity of milk ingested is probably critical to the beneficial immunological effects of BF against childhood cancer if any.
Chen, Chien-Fu; Hsu, Mei-Ching; Shen, Chin-Hua; Wang, Chun-Lung; Chang, Shou-Chin; Wu, Keng-Gu; Wu, Shiao-Chi; Chen, Shu-Jen
The Baby-Friendly Hospital Initiative began promoting exclusive breast-feeding in 2001 in Taiwan; however, few studies have investigated its impact. This study evaluated the influence of breast-feeding on Taiwanese neonates with regard to the frequency of jaundice, body weight loss (BWL), and elimination of both urine and stool. The medical records of 313 healthy mother-neonate pairs admitted at our hospital were reviewed retrospectively and divided into three groups: exclusively breast-feeding (n=161), mixed (breast/formula) feeding (n=80), and exclusively formula feeding (n=72). Compared with the exclusively formula feeding group, in the exclusively breast-fed neonates, the average total serum bilirubin level at 3 days after birth (p < 0.001) and the rate of significant hyperbilirubinemia ≥ 15 mg/dL (p<0.05) were significantly higher; the average BWLs at 2 and 3 days after birth (p < 0.001, p < 0.001) and the rate of BWL ≥ 10% (p < 0.05) were significantly higher; the average frequency of stool passage at 2 and 3 days after birth (p < 0.001, p < 0.001) and urination at 1, 2, and 3 days after birth (p < 0.001, p < 0.001, p < 0.001) were significantly less. The factors associated with a mother's choice of infant feeding type include maternal age and delivery method. Breast-feeding during the initial days of life has a significant influence on the degree of jaundice, amount of BWL, and the frequency of stool passage and urination. Copyright © 2011. Published by Elsevier B.V.
Cantrill, Ruth M; Creedy, Debra K; Cooke, Marie
To investigate midwives' breast-feeding knowledge, assess associations between knowledge and role, and report on the validity and reliability of the Breast-feeding Knowledge Questionnaire for the Australian context. Postal questionnaire. National Australia. Midwives (n=3500) who are members of the Australian College of Midwives Inc (ACMI). A response rate of 31% (n=1105) was obtained. Respondents were knowledgeable of the benefits of breast feeding and common management issues. Key areas requiring attention included management of low milk supply, immunological value of human milk, and management of a breast abscess during breast feeding. Participants over the age of 30, possessing IBCLC qualifications; having personal breast-feeding experience of more than three months; and more clinical experience achieved higher knowledge scores. Role perceptions were positive with 90% of midwives reporting being confident and effective in meeting the needs of breast-feeding women in the early postnatal period. Midwives' role perception contributed 39% of the variance in general breast-feeding knowledge scores and was a significant predictor of participants' breast-feeding knowledge. The level of basic breast-feeding knowledge of Australian midwives was adequate but there are deficits in key areas. Knowledge variations by midwives may contribute to conflicting advice experienced by breast-feeding women. Further research is needed to investigate in-depth breast-feeding knowledge, breast-feeding promotion practices, and associations between knowledge and practice.
... page: https://medlineplus.gov/news/fullstory_164574.html Breast-Feeding Success Hinges on Support for Mom, Baby Limiting ... Information and support can help new mothers overcome breast-feeding difficulties, a lactation expert says. A pregnant woman ...
Kools, Els J; Thijs, Carel; Kester, Arnold D M; de Vries, Hein
The aim of this study was to evaluate the motivational determinants of the continuation of breast-feeding until 3 months postpartum. A prospective cohort study using the Integrated Change Model in 341 women in 5 child health care centers. At birth, 73% of the mothers started with breast-feeding and 39% of them continued at least 3 months postpartum. Mothers who continued for 3 months differed in almost all the motivational determinants from mothers who discontinued. In the multiple logistic regression analysis, social support for formula feeding from significant others and situational self-efficacy for breast-feeding made a significant independent contribution to the continuation of breast-feeding. Among the predisposing determinants, the strongest positive predictor of continuation was the intention to return to work at 1 month postpartum. The Integrated Change Model is valid to explain and predict the continuation of breast-feeding. Hence, the results may be used to tailor future interventions aimed at promoting breast-feeding. In the discussion, we use the results to target interventions.
Fergusson, David M; McLeod, Geraldine F H; Horwood, L John
This study examined the associations between duration of breast feeding, early infant growth, and body mass index (BMI) at 30 and 35 years, in a birth cohort studied to age 35. Data were gathered on duration of exclusive and non-exclusive breast feeding (months), early growth (kg; 0-9 months), and BMI at ages 30 and 35 from the Christchurch Health and Development Study. The Christchurch Health and Development Study is a study of a birth cohort of 1265 children, born in Christchurch in 1977. Population-averaged generalised estimating regression models showed statistically significant associations between: duration of breast feeding and mean BMI; and early growth and mean BMI. After adjustment for perinatal, family, and social background factors, statistically significant associations were found between: longer duration of breast feeding and lower adult BMI (B = -0.424 [95% confidence interval (CI) -0.708, -0.140]); and increasing early growth and higher adult BMI (B = 0.393 [95% CI 0.080, 0.707]). When breast feeding and infant growth were entered into the regression model and adjusted for covariates, breast feeding was no longer statistically significantly associated with BMI (B = -0.250 [95% CI -0.553, 0.054]), while early growth remained statistically significantly associated with BMI (B = 0.355 [95% CI 0.039, 0.671]). A test for mediation showed that the association between breast feeding and BMI was mediated by early growth (P = 0.01). The association between longer duration of breast feeding and later lower BMI scores in adulthood was mediated by lower early growth. Breast feeding may be included as one component of multicompartment programmes targeted at early growth and later obesity. © 2014 John Wiley & Sons Ltd.
Fallahzadeh, Hossien; Golestan, Motahareh; Rezvanian, Taybeh; Ghasemian, Zahra
The relationship between breast-feeding history and risk of overweight in pre-adolescent children was investigated. Children's breast-feeding history and demographics were obtained in interviewer-administered questionnaires of a multistage cluster sample survey of 800 parents of children aged 11-13 years living in Yazd, Iran. Height and weight were measured in the children. Overweight was defined as body mass index >/=90th age- and sex-specific percentile of the 2000 Centers for Disease Control reference values. One hundred and four (13.0%) of 800 children were overweight. A total of 783 (97.9%) of the children had been breast fed. There was a markedly lower overweight prevalence among breast-fed than non breast-fed children. Controlling for age and sex, children breast fed for at least 24 months were substantially less likely to be overweight than children breast fed for less than 12 months (OR 0.56, 95% CI 0.31-0.9). A longer overall duration and duration of exclusive breast-feeding were associated significantly with the decreasing prevalence of overweight. This sample of Iranian children shows high rates of overweight at young ages but also high rates of breast-feeding. The duration of breast-feeding is inversely related with the prevalence of overweight in pre-adolescent children.
Tully, Kristin P; Ball, Helen L
breast-feeding outcomes are often worse after caesarean section compared to vaginal childbirth. this study characterises mothers' breast-feeding intentions and their infant feeding experiences after caesarean childbirth. data are from 115 mothers on a postnatal unit in Northeast England during February 2006-March 2009. Interviews were conducted an average of 1.5 days (range 1-6 days) after the women underwent unscheduled or scheduled caesarean. thematic analysis of the data suggested was mostly considered the 'right thing to do,' preferable, natural, and 'supposedly healthier,' but tiring and painful. Advantages of supplementation involved more satiated infants, feeding ease, and longer sleep bouts. The need for 'thinking about yourself' was part of caesarean recovery. Infrequent feeding was concerning but also enabled maternal rest. Other breast-feeding obstacles were maternal mobility limitations, positioning difficulties, and frustration at the need for assistance. Participants were confused about nocturnal infant wakings, leading many to determine that they had insufficient milk. Mothers were surprised that sub-clinically poor infant condition was common following caesarean section. Some breast-feeding difficulty stemmed from 'mucus' expulsion that had to occur before the infants could be 'interested' in feeding. Women who cited motivations for breast feeding that included benefit to themselves were more likely to exclusively breast feed on the postnatal unit after their caesareans than those who reported infant-only motivations. for the majority of mothers, breast feeding after a caesarean is affected by interrelated and compounding difficulties. Provision of more relational breast-feeding information may enable families to better anticipate early feeding experiences after caesarean section childbirth. © 2013 Elsevier Ltd. All rights reserved.
The Department of Health and the World Health Organization recommend that mothers should exclusively breast-feed their infants for the first six months of their lives. Very few mothers in the UK achieve this, but with good support and encouragement from health professionals this could be attained. Health professionals, however, need to have knowledge of the process of breastfeeding and be able to adopt a problem-solving approach to the difficulties mothers encounter, in order to give appropriate evidence-based care.
Pollard, Deborah L
Even with the gradual upward trends in breastfeeding initiation and duration, breastfeeding rates at 6 months continue to lag well behind the 50% target set for any breastfeeding and the 25% target set for exclusive breastfeeding by the Healthy People 2010 initiatives. Overall evidence is limited in identifying effective interventions that promote breastfeeding duration and more research needs to be focused on specific nursing strategies and their effect on breastfeeding outcomes. The aim of this study was to test the efficacy of a daily feeding log, guided by Bandura's social cognitive learning theory, on breastfeeding duration and exclusivity in primiparous mothers. The study used a randomized, controlled, two-group experimental design with a sample of 86 primiparous mothers. The experimental group completed a daily breastfeeding log for a minimum of 3 weeks and breastfeeding outcomes were examined over 6 months. The breastfeeding outcome variable was analyzed using survival analysis and Cox proportional hazards regression procedures. Subjects in the experimental group did not breastfeed significantly longer than the control group, however, a larger proportion of subjects in the experimental group reported full breastfeeding at 6 months as compared with subjects in the control group. Additional predictor variables were WIC enrollment, planned duration of breastfeeding, feeding frequency and feeding length at 1 week. The findings from the study suggest that the breastfeeding log may be a valuable tool in self-regulating breastfeeding and promoting a longer duration of full breastfeeding, but its acceptability may be impacted by socio-demographic variables.
Mezzacappa, E S; Guethlein, W; Vaz, N; Bagiella, E
The association between breast-feeding status and maternal health is examined. A survey questionnaire was presented via the World Wide Web. Self-reports of 168 breast-feeding and 65 weaned mothers between 4 and 208 weeks postpartum were compared for physician visits, symptomatology, and Perceived Stress Scale scores in the last month. Breast-feeding was associated with fewer physician visits and symptoms and less perceived stress. Moreover, the longer a woman breast-fed before she weaned, the fewer the symptoms and less stress she reported. Breast-feeding is associated with better maternal health both during the breast-feeding period and after weaning. Further research on the effects on maternal health of breast-feeding is indicated. Future prospective longitudinal investigations should address the possible inhibition of lactation by stress and physiological mechanisms that may link breast-feeding and weaning with maternal health.
Ingram, Jenny; Johnson, Debbie; Copeland, Marion; Churchill, Cathy; Taylor, Hazel
Objective to develop a breast feeding assessment tool to facilitate improved targeting of optimum positioning and attachment advice and to describe the changes seen following the release of a tongue-tie. Design development and validation of the Bristol Breastfeeding Assessment Tool (BBAT) and correlation with breast feeding self-efficacy. Setting maternity hospital in South West England. Participants 218 breast feeds (160 mother–infant dyads); seven midwife assessors. Findings the tool has more explanation than other tools to remind those supporting breast-feeding women about the components of an efficient breast feed. There was good internal reliability for the final 4-item BBAT (Cronbach׳s alpha=0.668) and the midwives who used it showed a high correlation in the consistency of its use (ICC=0.782). Midwives were able to score a breast feed consistently using the BBAT and felt that it helped them with advice to mothers about improving positioning and attachment to make breast feeding less painful, particularly with a tongue-tied infant. The tool showed strong correlation with breast feeding self-efficacy, indicating that more efficient breast feeding technique is associated with increased confidence in breast feeding an infant. Conclusions the BBAT is a concise breast feeding assessment tool facilitating accurate, rapid breast feeding appraisal, and targeting breast feeding advice to mothers acquiring early breast feeding skills or for those experiencing problems with an older infant. Accurate assessment is essential to ensure enhanced breast feeding efficiency and increased maternal self-confidence. Implications for practice the BBAT could be used both clinically and in research to target advice to improve breast feeding efficacy. Further research is needed to establish its wider usefulness. PMID:25061006
Ingram, Jenny; Johnson, Debbie; Copeland, Marion; Churchill, Cathy; Taylor, Hazel
to develop a breast feeding assessment tool to facilitate improved targeting of optimum positioning and attachment advice and to describe the changes seen following the release of a tongue-tie. development and validation of the Bristol Breastfeeding Assessment Tool (BBAT) and correlation with breast feeding self-efficacy. maternity hospital in South West England. 218 breast feeds (160 mother-infant dyads); seven midwife assessors. the tool has more explanation than other tools to remind those supporting breast-feeding women about the components of an efficient breast feed. There was good internal reliability for the final 4-item BBAT (Cronbach's alpha=0.668) and the midwives who used it showed a high correlation in the consistency of its use (ICC=0.782). Midwives were able to score a breast feed consistently using the BBAT and felt that it helped them with advice to mothers about improving positioning and attachment to make breast feeding less painful, particularly with a tongue-tied infant. The tool showed strong correlation with breast feeding self-efficacy, indicating that more efficient breast feeding technique is associated with increased confidence in breast feeding an infant. the BBAT is a concise breast feeding assessment tool facilitating accurate, rapid breast feeding appraisal, and targeting breast feeding advice to mothers acquiring early breast feeding skills or for those experiencing problems with an older infant. Accurate assessment is essential to ensure enhanced breast feeding efficiency and increased maternal self-confidence. the BBAT could be used both clinically and in research to target advice to improve breast feeding efficacy. Further research is needed to establish its wider usefulness. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.
Rieken, Susan E; Terezhalmy, Geza T
The pregnant or breast-feeding patient presents a number of unique management problems for oral health care providers. Clinicians are responsible for providing safe and effective care for the mother, while also considering the safety of the fetus or newborn. They must consider the effects of medications, which may be distributed from the maternal plasma through the placenta to the fetus, or to breast milk, exposing the nursing infant to potentially dangerous concentrations. In addition, a number of maternal oral changes, requiring the attention of oral health care providers, may be observed as a consequence of the multiple physiologic changes associated with pregnancy. In view of the dual responsibility that oral health care providers face in treating the pregnant or breast-feeding patient, understanding the physiology of pregnancy, fetal development, potential oral complications of pregnancy, and the effects that dental intervention may have on the woman, her fetus, or her neonate are imperative.
Torres de Lacerda, Ana Catarina; Lucena de Vasconcelos, Maria Gorete; Nascimento de Alencar, Eloine; Osório, Mônica Maria; Pontes, Cleide Maria
to understand the ways in which adolescent fathers participate in the breast feeding process in the family environment in North-eastern Brazil. a descriptive, exploratory, qualitative study was undertaken involving 10 couples with infants aged 6-8 months living in a single community in Recife, Pernambuco, Brazil. Data were collected using semi-structured interviews with questions to guide the interviewer. Data were analysed using thematic content analysis, and interpreted under the theoretical reference of being an adolescent father within the context of breast feeding. from the data collected, three themes were identified: knowledge of the benefits of breast feeding for the child's health; discontinued participation of the father in breast feeding during the pregnancy-childbearing cycle; and exclusion of the adolescent father from the breast feeding process. The adolescent fathers knew about the benefits of breast feeding in terms of the child's health, but did not mention benefits for the mother, the family or society. For some adolescent fathers, their participation in the breast feeding process started during pregnancy, whereas for others, it was only initiated after the infant was born. One of the fathers was prevented, by his wife and mother-in-law, from participating in the breast feeding process. the involvement of adolescent fathers in the breast feeding process oscillated during the pregnancy-childbearing cycle. This may be due to the patriarchal cultural heritage, Brazilian paternity laws, and the fact that these fathers were adolescents. This study showed that adolescent parents were knowledgeable about breast feeding. Finally, fathers want a new model of parenting in which the man participates in child care. Crown Copyright © 2013. Published by Elsevier Ltd. All rights reserved.
Mizuno, Katsumi; Ueda, Aki
Our aim was to obtain a better understanding of the differences between breast-feeding and bottle-feeding, particularly with regard to how sucking performance changes from nonnutritive sucking (NNS) to nutritive sucking (NS). Twenty-two normal term infants were studied while breast-feeding at 4 and 5 d postpartum. Five of the 22 infants were exclusively breast-fed, but we tested the other 17 infants while breast-feeding and while bottle-feeding. Before the milk ejection reflex (MER) occurs, little milk is available. As such, infants perform NNS before MER. For bottle-feeding, a one-way valve was affixed between the teat and the bottle so that the infants needed to perform NNS until milk flowed into the teat chamber. At the breast, the sucking pressure (-93.1 +/- 28.3 mm Hg) was higher during NNS compared with NS (-77.3 +/- 27.0 mm Hg). With a bottle, the sucking pressure was lower during NNS (-27.5 +/- 11.2 mm Hg) compared with NS (-87.5 +/- 28.5 mm Hg). Sucking frequency was higher and sucking duration was shorter during NNS compared with that during NS both at the breast and with a bottle. There were significant differences in the changes of sucking pressure and duration from NNS to NS between breast- and bottle-feeding. The change in sucking pressure and duration from NNS to NS differed between breast-feeding and bottle-feeding. Even with a modified bottle and teats, bottle-feeding differs from breast-feeding.
Agne-Djigo, Anta; Kwadjode, Komlan M; Idohou-Dossou, Nicole; Diouf, Adama; Guiro, Amadou T; Wade, Salimata
Exclusive breast-feeding until 6 months is advised by the WHO as the best practice to feed infants. Yet, some studies have suggested a gap between energy requirements and the energy provided by human milk for many infants at 6 months. In order to assess the adequacy of WHO recommendations in 6-month-old Senegalese lactating infants, a comprehensive study was designed to measure human milk intake by the dose-to-the mother 2H2O turnover method. Infants’ energy intakes were calculated using daily breast milk intake and the energy content of milk was estimated on the basis of creamatocrit. Of the fifty-nine mother–infant pairs enrolled, fifteen infants were exclusively breast-fed (Ex) while forty-four were partially breast-fed (Part). Infants’ breast milk intake was significantly higher in the Ex group (993 (SD 135) g/d, n 15) compared with the Part group (828 (SD 222) g/d, n 44, P¼0·009). Breast milk energy content as well as infants' growth was comparable in both groups. However, infants’ energy intake from human milk was significantly higher (364 (SD 50) kJ/kg per d (2586 (SD 448) kJ/d)) in the Ex group than in the Part group (289 (SD 66) kJ/kg per d (2150 (SD 552) kJ/d), P,0·01). Compared with WHO recommendations, the results demonstrate that energy intake from breast milk was low in partially breast-fed infants while exclusively breast-fed 6-month-old Senegalese infants received adequate energy from human milk alone, the most complete food for infants. Therefore, advocacy of exclusive breast-feeding until 6 months should be strengthened.
Focusing on the issue of feeding infants, this journal covers a wide range of information, research, and issues related to breast-feeding and its alternatives for feeding infants in both developing and industrialized countries. The journal is divided into the following sections: (1) "The Epidemiology of Breast-feeding: Frequency and…
Kramer, Michael S; Matush, Lidia; Vanilovich, Irina; Platt, Robert W; Bogdanovich, Natalia; Sevkovskaya, Zinaida; Dzikovich, Irina; Shishko, Gyorgy; Collet, Jean-Paul; Martin, Richard M; Smith, George Davey; Gillman, Matthew W; Chalmers, Beverley; Hodnett, Ellen; Shapiro, Stanley
The evidence that breast-feeding protects against obesity is based on observational studies, with potential for confounding and selection bias. This article summarizes a previously published study in which we assessed whether an intervention designed to promote exclusive and prolonged breast-feeding affects children's height, weight, adiposity, and blood pressure (BP) at age 6.5 y. The Promotion of Breastfeeding Intervention Trial (PROBIT) is a cluster-randomized trial of a breast-feeding promotion intervention based on the WHO/UNICEF Baby-Friendly Hospital Initiative. A total of 17,046 healthy breast-fed infants were enrolled from 31 Belarussian maternity hospitals and affiliated clinics, of whom 13,889 (81.5%) were followed up at 6.5 y with duplicate measurements of height, weight, waist circumference, triceps and subscapular skinfold thicknesses, systolic and diastolic BP. Analysis was based on intention to treat, with statistical adjustment for clustering within hospitals/clinics to permit inferences at the individual level. The experimental intervention led to a large increase in exclusive breast-feeding at 3 mo (43.3% vs. 6.4%, P < 0.001) and a significantly higher prevalence of any breast-feeding throughout infancy. No significant intervention effects were observed on height, BMI, adiposity measures, or BP. The breast-feeding promotion intervention resulted in substantial increases in the duration and exclusivity of breast-feeding yet did not reduce measures of adiposity at age 6.5 y. Previous reports of protective effects against obesity may reflect uncontrolled bias caused by confounding and selection.
Khan, Moazzam Ali; Qureshi, Zubia; Khan, Kauser Aftab; Gill, Fouzia Nadeem
Proper breastfeeding practices are effective ways for reducing childhood morbidity and mortality. The objective of the present study was to determine the patterns and explore the determinants associated with breast feeding practices among the nursing women in Dera Ghazi Khan. A cross sectional study was conducted on randomly selected lactating mother infant pairs in Dera Ghazi Khan. Structured questionnaire was used for data collection. Analysis was done by using SPSS, chi square test was applied to see the association between breast feeding practices and its determinants such as knowledge of breast feeding practices. Majority 372 (93%) of mothers mentioned that they had ever breastfed the youngest child. About 292 (73%) mothers gave colostrum to the child, and 48 (12%) exclusively breastfed. Weaning babies before four month of age was practiced by 84 (21%) of the mothers, 120 (55%) mothers started weaning at 4-6 months of child age, while 72 (18%) started to give additional food after baby turned six months old. Out of total 276 (69%) mothers reported that they had knowledge regarding breast feeding. Significant association was found between knowledge of breastfeeding and initiation and Exclusive Breast Feeding (EBF) practices (p-values <0.05). Income, family type, mode of delivery and assistance for child were significantly associated with initiation of breastfeeding within one hour after birth (p-value <0.001). Breast feeding practices in the studied area were not up to the mark. There is a strong need to improve the breastfeeding practices by Behavior Change Communication.
Kunwar, Shipra; Faridi, Mohammad M A; Singh, Shivani; Zahra, Fatima; Alizaidi, Zeashan
The present study aims to determine the patterns of breast feeding, return of menstruation, and contraceptive practices in the first six months postpartum in women visiting the outpatient department at a teaching hospital in Lucknow, Northern India. Mothers of infants between six to eight months of age visiting the outpatient department of Era's Lucknow Medical College were interviewed regarding breast feeding practices, return of menstruation, sexual activity, and contraceptive practices within the first six months postpartum using a structured questionnaire. Of all women interviewed only 75.8% practiced exclusive breast feeding with the mean duration of exclusive breast feeding (EBF) being 3.5 months with only 41% practicing EBF for six months, 28% were sexually active within six weeks postpartum, 64.5% women had a return of menstruation within six months. Contraception was practiced by only 54.4% women with a barrier method such as a condom, being the most common. Better education was the only factor significantly affecting EBF (p < 0.004) and use of contraception (p < 0.027). There were a total of 10 pregnancies within six months postpartum. In conclusion, optimal breast feeding practices are poor in this part of the country and lactational amenorrhoea cannot be effectively and reliably used as a method of contraception. Therefore, optimal breast feeding practices, timely introduction of contraception and institutional delivery need to be encouraged.
Breast-feeding is a part of the Government health agenda with a particular emphasis on encouraging those mothers who are least likely to breast-feed. Current and recent breast-feeding support materials from the Department of Health outline good practice for Primary Care Trusts, in line with targets for the increase in breast-feeding initiation. Breast-feeding reduces health inequalities, in the short and long term. The 2005 National Breastfeeding Awareness Week has the key message "Give it a go!" and materials including a Local Action booklet are available.
Attention-deficit/hyperactivity disorder (ADHD) is one of the most common neurodevelopmental disorders that develop in children. In the United States and Canada, the prevalence is about 6%. The causes of ADHD are not known. ADHD, like autism, occurs mainly in boys aged 3-6, and there are some thoughts that both diseases may have a common mechanism. This study uses nutritional epidemiology linked to exclusive 6-month breast-feeding. The Centers for Disease Control and Prevention (CDC) has reported in 2003 and 2007 extensive studies on ADHD involving several million children in 50 states. The prevalence of ADHD in each state in 2003 or 2007 was compared to the average of exclusive 6-month breast-feeding from 2001 to 2004 or 3-month exclusive breast-feeding in 2007 in each of the 50 states. Several parameters, such as premature births, low birth weight, and very low birth weight, that had previously associated with ADHD were compared to ADHD incidence. Other parameters such as obesity, infant death rate, neonatal death rate, poverty, per capita income, and the percentage of individuals enrolled in the U.S. WIC (Women, Infants, and Children) program were also compared to ADHD incidence. A highly significant inverse relationship of ADHD to exclusive 6-month and 3-month breast-feeding in 2007 was observed. Direct relationships were observed between premature births, low birth weight and very low birth weight, obesity, infant deaths, neonatal deaths, and ADHD. Breast milk contains components that appear to prevent ADHD.
Scott, Allison; Shreve, Marilou; Ayers, Britni; McElfish, Pearl Anna
To determine perceptions, beliefs and experiences affecting breast-feeding in Marshallese mothers residing in Northwest Arkansas, USA. A qualitative, exploratory study using a brief survey and focus groups. Marshallese women, 18 years or older who had a child under 7 years of age, were included in the study. Community-based organization in Northwest Arkansas. The majority of mothers viewed breast milk as superior to formula, but had concerns about adequate milk supply and the nutritional value of their milk. The primary barriers to exclusive breast-feeding in the USA included public shaming (both verbal and non-verbal), perceived milk production and quality, and maternal employment. These barriers are not reported in the Marshall Islands and are encountered only after moving to the USA. Breast-feeding mothers rely heavily on familial support, especially the eldest female, who may not reside in the USA. The influence of institutions, including the Special Supplemental Nutrition Program for Women, Infants, and Children, is strong and may negatively affect breast-feeding. Despite the belief that breast milk is the healthiest option, breast-feeding among Marshallese mothers is challenged by numerous barriers they encounter as they assimilate to US cultural norms. The barriers and challenges, along with the strong desire to assimilate to US culture, impact Marshallese mothers' perceptions, beliefs and experiences with breast-feeding.
Leviniene, Giedra; Petrauskiene, Ausra; Tamuleviciene, Egle; Kudzyte, Jolanta; Labanauskas, Liutauras
The objective of this study was to evaluate the knowledge and activities of Kaunas primary health care center professionals in promoting breast-feeding. A total of 84 general practitioners and 52 nurses participated in the survey, which was carried out in Kaunas primary health care centers in 2006. Data were gathered from the anonymous questionnaire. Less than half of general practitioners (45.1%) and 65% of nurses were convinced that baby must be exclusively breast-fed until the age of 6 months, but only 21.6% of general practitioners and 27.5% of nurses knew that breast-feeding with complementary feeding should be continued until the age of 2 years and longer. Still 15.7% of general practitioners and 25% of nurses recommended pacifiers; 7.8% of general practitioners advised to breast-feed according to hours. Half of the health professionals recommended additional drinks between meals; one-third of them--to give complementary food for the babies before the age of 6 months. One-third (29.6%) of the health professionals surveyed recommended mothers to feed their babies more frequently in case the amount of breast milk decreased. The survey showed that knowledge of medical personnel in primary health care centers about the advantages of breast-feeding, prophylaxis of hypogalactia, and duration of breast-feeding was still insufficient.
Schmied, V; Sheehan, A; Barclay, L
In this paper, the authors draw upon recent Australian research to provide a critical commentary on the current policies and professional practices surrounding breast feeding. These studies, conducted by the first and second authors, explored aspects of the breast-feeding experience, with the findings highlighting areas for concern in relation to the promotion and support of breast feeding in western societies. Of particular concern to the authors was the number of women in these studies who equated breastfeeding with being a 'good' mother. This perception meant that some women maintained a strong commitment to breast feeding despite enormous difficulties. In this paper we firstly, overview the findings of these studies and use women's stories to illustrate their perseverance and their intense commitment to breast feeding. In the second part of the paper, we consider the consequences of the strong public rhetoric surrounding breast feeding in Australia and challenge some of the assumptions underlying policies and professional practices related to breast feeding. We examine the consequences of 'professionalising' breast feeding, and make suggestions for a way forward in the promotion of breast feeding that encompasses the range of perspectives held by women. In conclusion, the authors highlight the complexity of establishing appropriate breast-feeding policies that guide professional practices in a flexible manner, allowing for diversity in individual breast-feeding experiences.
Grassley, Jane S; Nelms, Tommie P
Nurses play a vital role in mothers' early experiences with breast-feeding. Literature enumerates both supportive and nonsupportive behaviors, as well as the "interpersonal" aspect of breast-feeding support, although little direction is given to nurses about how to facilitate the relationship. This article conceptualizes breast-feeding support within Gadamerian hermeneutics as a conversation among nurses, mothers, and their newborns. Hermeneutically, breast-feeding conversation encompasses a text (a particular feeding at the breast), conversational partners (a mother, her newborn, and a nurse), and a dialogue that facilitates effective breast-feeding and maternal breast-feeding confidence through interpretation or understanding of the text. History and language are essential as a partnership is formed.
Mezzacappa, Elizabeth Sibolboro; Guethlein, William; Katkin, Edward S
Self-reports of mothers currently breast-feeding (n = 561) and mothers who had breast-fed in the past (n = 452) were compared for perceived stress, self-reports of upper respiratory infection symptoms, and physician visits for psychological illnesses. Possible demographic confounds were controlled statistically. In analyses examining breast-feeding status as a dichotomous variable (current vs. past), breast-feeding was negatively associated with perceived stress and upper respiratory symptoms (the latter association dissolved when controlling for perceived stress), but not with physician visits for psychological illnesses. However, analyses of the continuous variables of frequency of breast-feeding and cumulative amount of breast-feeding revealed negative associations, and analyses of times since last nursing revealed positive associations with likelihood for physician visits for psychological illnesses. Frequency of bottle-feeding was positively associated with perceived stress. The results support the interrelatedness of breast-feeding and maternal health in online mothers.
Barona-Vilar, Carmen; Escribá-Agüir, Vincenta; Ferrero-Gandía, Raquel
to explore pregnant women's perceptions and personal experiences of the influence of formal and informal social support on breast-feeding decision-making, in relation to breast-feeding initiation and duration. qualitative focus groups and interviews. four primary-care centres in Valencia, Spain. 19 primiparous women in their first trimester of pregnancy participated in focus groups and 12 primiparous and multiparous women in their third trimester of pregnancy participated in interviews. Women had different socio-demographic backgrounds and socio-economic status. women's perceptions and personal experiences of formal and informal social support of breast feeding may be linked to age and socio-cultural status. Women from higher socio-cultural backgrounds took their partner's opinion and support more into account when choosing breast feeding. They also conceded great importance to formal health support, and employed mothers wished to have more institutional support. Among women from lower socio-cultural backgrounds, friends were the closest social network and had the greatest influence on feeding decisions. They perceived some contradictions in health-promotion messages on breast feeding, and most of them preferred to leave work after birth to exclusively care for their baby. Younger women, without previous experience of breast feeding or possibility of receiving tangible support from their mothers, wanted more practical health-care support (e.g. providing skills in breast-feeding technique). breast-feeding promotion strategies should take into account women's different characteristics. Health professionals should consider offering postnatal support as a follow-up to practical support (e.g. breast-feeding workshops).
Mannan, H R; Islam, M N
Data from the 1989 Bangladesh Fertility Survey and actuarial life table methods are used to estimate breast feeding differences by other socioeconomic, health, and demographic characteristics. Findings indicate that the average breast feeding duration for surviving children was 28.2 months (27.1 months for urban women and 28.6 months for rural women). Breast feeding duration was longer among mothers with no schooling compared to mothers or fathers with a higher education. Older mothers had different breast feeding patterns than younger mothers. Muslim women breast fed for 28.1 months; non-Muslim women did so for 18.8 months. Working women breast fed for 19.0 months compared to 28.1 months among non-working women. Duration of breast feeding increased with increased parity. Breast feeding duration averaged 17.5 months among wives of service workers and business men, 28.3 months among wives of production workers, and 29.0 and 27.9, respectively, for wives of farmers and land-owners. Contraceptive use was unrelated to breast feeding duration. Women who possessed specific household items had a shorter breast feeding period. Women who were visited by health workers had a longer breast feeding duration. There were only marginal differences between durations by whether husbands controlled health decision making or whether there was joint decision making. Gender was unrelated to duration. Differences in the significance between variables and survival are reported. Multivariate findings among women who ceased breast feeding indicate that breast feeding had a positive significant effect on amenorrhea and directly determined both closed and open birth intervals. The effect of breast feeding on amenorrhea was stronger in the closed interval. Breast feeding explained 18.9% of variation in postpartum amenorrhea (9.8% in the current open interval). 86.9% of the variance was explained by place of residence, maternal education and age, parity, maternal work status, and every use of
Oddie, S; Richmond, S; Coulthard, M
As part of a population based regional review of all neonatal readmissions, the incidence of dehydration with hypernatraemia in exclusively breast fed infants was estimated. All readmissions to hospital in the first month of life during 1998 from a population of 32 015 live births were reviewed. Eight of 907 readmissions met the case definition, giving an incidence of at least 2.5 per 10 000 live births. Serum sodium at readmission varied from 150to 175 mmol/l. One infant had convulsions. The sole explanation for hypernatraemia was unsuccessful breast feeding in all cases. The eight cases are compared with the 65 cases published in the literature since 1979. Presentation, incidence, risk factors, pathophysiology, treatment, and prevention are discussed. PMID:11567942
Driul, L; Forzano, L; Londero, A P; Fachechi, G; Liva, S; Marchesoni, D
The aim of this paper was to determine whether maternal BMI influences breast-feeding practice in quality and duration A retrospective case-control study were included Fifty women with Body Max Index (BMI) ≥25 kg/m2 considered overweigh and obese and fifty controls with BMI<25 kg/m2 who delivered in our clinic between 2010 and 2011. The incidence of breast-feeding was significantly lower in overweight and obese women compared with normal weight. Breastfeeding length was negatively related to prepregnancy BMI but not to gestational weight gain, method of delivery or lactation integration. Obese women presented an elevated Body Max Index one year apart from childbirth and are correlated to maternal complications during breastfeeding. Maternal overweight and obesity is negatively correlated to duration and quality of lactation.
Theobald, Hannah E
Good nutrition is essential to help support a successful pregnancy and breast-feeding. Women planning a pregnancy should follow a balanced nutrient-rich diet and consume a daily folic acid supplement up until the end of the first trimester. Many pregnancies, especially amongst teenagers, are unplanned, and educating women of childbearing age about the need to take folic acid to prevent neural tube defects is important. Maintaining a healthy body weight and weight gain is also important: if the mother is underweight, overweight or obese this can harm the health of both mother and fetus. Care should be taken to monitor the nutritional status of vulnerable groups (e.g. teenagers, vegans, women who are underweight, and those at risk of too little vitamin D) to ensure a healthy pregnancy outcome. During breast-feeding the mother needs to eat a sufficient and nutrient-rich diet to provide enough energy and nutrients to support milk production.
Engebretsen, Ingunn Ms; Moland, Karen M; Nankunda, Jolly; Karamagi, Charles A; Tylleskär, Thorkild; Tumwine, James K
In resource-poor settings, HIV positive mothers are recommended to choose between 'Exclusive breastfeeding' (EBF) or 'Exclusive replacement feeding' (ERF). Acceptability, Feasibility, Affordability, Sustainability and Safety (AFASS) has been the World Health Organization (WHO)'s a priori criteria for ERF the last ten years. 'AFASS' has become a mere acronym among many workers in the field of prevention of mother-to-child transmission of HIV, PMTCT. Thereby, non-breastfeeding has been suggested irrespective of social norms. EBF for the first half of infancy is associated with huge health benefits for children in areas where infant mortality is high. But, even if EBF has been recommended for a decade, few mothers are practicing it. We set out to understand fathers' and mothers' infant feeding perceptions and the degree to which EBF and ERF were 'AFASS.' Eight focus groups with 81 informants provided information for inductive content analysis. Four groups were held by men among men and four groups by women among women in Mbale District, Eastern Uganda. Two study questions emerged: How are the different feeding options understood and accepted? And, what are men's and women's responsibilities related to infant feeding? A mother's commitment to breastfeed and the husband's commitment to provide for the family came out strongly. Not breastfeeding a newborn was seen as dangerous and as unacceptable, except in cases of maternal illness. Men argued that not breastfeeding could entail sanctions by kin or in court. But, in general, both men and women regarded EBF as 'not enough' or even 'harmful.' Among men, not giving supplements to breast milk was associated with poverty and men's failure as providers. Women emphasised lack of time, exhaustion, poverty and hunger as factors for limited breast milk production. Although women had attended antenatal teaching they expressed a need to know more. Most men felt left out from health education. Breastfeeding was the expected way to
Olayemi, O; Aimakhu, C O; Bello, F A; Motayo, V O; Ogunleye, A A; Odunukan, O W; Ojengbede, O A
In Nigeria, breast-feeding has been shown to be very closely related to infant survival. Prolonged and adequate breast-feeding is critical to most infants' nutritional health and growth. This study aims to determine the influence of family support on the duration of exclusive and total breast-feeding of infants of antenatal patients. This cross-sectional study was conducted between 1 September and 30 December 2005. The tool was a structured questionnaire. The main outcome variables were the duration of breast-feeding; both total and exclusive explanatory variables were mainly related to support obtained during breast-feeding from husband and older female relations. Husbands support significantly increased the total duration of breast-feeding by a mean of 1.69 months (95% CI 0.88, 2.51), however, exclusive breast-feeding was not significantly affected by the husband's support (OR 0.94; 95% CI 0.63, 1.39). Female support had a significant influence on both the total duration of breast-feeding which is increased by a mean of 1.08 months (95% CI 0.14, 2.02), and the adequate conduct of exclusive breast-feeding (OR 1.83; 95% CI 1.17, 2.86). The cultural practice of having additional female support in the postpartum period has been shown by this study to be beneficial. Therefore, this cultural practice should be encouraged and catalogued as a beneficial cultural practice. This practice is also cheap and sustainable.
Yamakawa, Michiyo; Yorifuji, Takashi; Kato, Tsuguhiko; Yamauchi, Yoshitada; Doi, Hiroyuki
Whether or not breast-feeding is protective against asthma among children is still controversial. Therefore, we examined the effects of breast-feeding on hospitalization for asthma in early childhood. Secondary data analyses of a nationwide longitudinal survey of children in Japan ongoing since 2001, with results collected from 2001 to 2004. We used logistic regression models to evaluate the associations of breast-feeding with hospitalization for asthma in children between the ages of 6 and 42 months, adjusting for children's factors (sex, day-care attendance and presence of older siblings) and maternal factors (educational attainment and smoking habit). Setting All over Japan. Term singleton children with information on feeding practices during infancy (n 43367). After adjusting for maternal factors and children's factors, exclusive breast-feeding at 6-7 months of age was associated with decreased risk of hospitalization for asthma in children. The adjusted odds ratio was 0.77 (95% CI 0.56, 1.06). One-month longer duration of breast-feeding was associated with a 4% decreased risk of hospitalization for asthma (OR = 0.96; 95% CI 0.92, 0.99). The protective effects of breast-feeding on hospitalization for asthma were observed in children between the ages of 6 and 42 months.
Chung, Woojin; Kim, Hanjoong; Nam, Chung-Mo
To investigate factors influencing the practices of partial breast-feeding (PBF) and exclusive breast-feeding (EBF). A national, cross-sectional survey was conducted among married women aged 15-49 years from May to August 2003. South Korea. A total of 865 mothers answered questions regarding the feeding practices of their youngest baby, born between January 2001 and May 2003. The initiation rates of PBF and EBF were 81% and 63%, respectively. However, the median durations of PBF and EBF were very short: 12 and 8 weeks, respectively. According to stepwise logistic and Cox regression analyses, the more prenatal care women received, the more likely they were to initiate PBF and EBF but the less likely to continue EBF. Delivery by Caesarean section decreased the initiation of PBF and EBF. The mother's education level and employment status before marriage, the amount of prenatal care, delivery method and baby's status at birth affected breast-feeding initiation, whereas the amount of prenatal care influenced breast-feeding duration. To promote breast-feeding, education and campaigning on the importance of continued breast-feeding should be provided to the general public, particularly to health workers in maternity units.
Nickerson, Lauren E; Sykes, Abby C; Fung, Teresa T
To examine mothers' experience of support received from fathers for breast-feeding. We conducted in-depth in-person interviews with women with recent breast-feeding experience. Interview transcripts were analysed by qualitative content analysis. Interviews were designed to explore the mothers' perception of role of fathers in breast-feeding, education on breast-feeding that fathers received and their perception of the fathers' view on breast-feeding. Urban and suburban community. Nineteen women from a metropolitan area in the north-eastern USA. Ten themes emerged, these involved practical and emotional support provided by fathers, especially during times of unexpected breast-feeding challenges. In addition, mothers perceived fathers may benefit from more peer and professional support, lactation consultant service and breast-feeding education. Mothers appreciated the support from fathers for breast-feeding continuation, including encouragement and understanding. These results may be useful for health-care practitioners to promote breast-feeding continuation by supporting fathers in their role in the breast-feeding process.
Kull, I; Wickman, M; Lilja, G; Nordvall, S L; Pershagen, G
To investigate the effect of breast feeding on allergic disease in infants up to 2 years of age. A birth cohort of 4089 infants was followed prospectively in Stockholm, Sweden. Information about various exposures was obtained by parental questionnaires when the infants were 2 months old, and about allergic symptoms and feeding at 1 and 2 years of age. Duration of exclusive and partial breast feeding was assessed separately. Symptom related definitions of various allergic diseases were used. Odds ratios (OR) and 95% confidence intervals (CI) were estimated in a multiple logistic regression model. Adjustments were made for potential confounders. Children exclusively breast fed during four months or more exhibited less asthma (7.7% v 12%, OR(adj) = 0.7, 95% CI 0.5 to 0.8), less atopic dermatitis (24% v 27%, OR(adj) = 0.8, 95% CI 0.7 to 1.0), and less suspected allergic rhinitis (6.5% v 9%, OR(adj) = 0.7, 95% CI 0.5 to 1.0) by 2 years of age. There was a significant risk reduction for asthma related to partial breast feeding during six months or more (OR(adj) = 0.7, 95% CI 0.5 to 0.9). Three or more of five possible allergic disorders-asthma, suspected allergic rhinitis, atopic dermatitis, food allergy related symptoms, and suspected allergic respiratory symptoms after exposure to pets or pollen-were found in 6.5% of the children. Exclusive breast feeding prevented children from having multiple allergic disease (OR(adj) = 0.7, 95% CI 0.5 to 0.9) during the first two years of life. Exclusive breast feeding seems to have a preventive effect on the early development of allergic disease-that is, asthma, atopic dermatitis, and suspected allergic rhinitis, up to 2 years of age. This protective effect was also evident for multiple allergic disease.
Guelinckx, Isabelle; Devlieger, Roland; Bogaerts, Annick; Pauwels, Sara; Vansant, Greet
To determine whether pre-pregnancy BMI influences breast-feeding practice. Retrospective epidemiological study. University Hospital Leuven, Catholic University Leuven, Belgium. Two hundred women (median age 29 years, interquartile range (IQR) 4; 52 % nulliparae) were grouped into four categories according to pre-pregnancy BMI using WHO cut-offs. The incidence of intention and initiation of breast-feeding was significantly lower in underweight (64 %) and obese women (68 %) compared with normal weight (92 %) and overweight women (80 %). Initiation was also related to parity (OR = 0.582; 95 % CI 0.400, 0.846), but not to gestational weight gain, method of delivery or hypertensive disorders. Fifty-two per cent of underweight, 70 % of normal weight and 56 % of overweight women were exclusively breast-feeding their infant during the first month of life. This incidence was significantly lower in the obese group (34 %; P = 0.030). Only 40 % of all infants were exclusively breast-fed at 3 months of age, with the lowest prevalence among women with obesity (P = 0.0 0 1). The median duration of any breast-feeding in the obese group (1.8 months, IQR 3.4) was significantly shorter than in the underweight (3.0 months, IQR 3.1), normal weight (3.0 months, IQR 2.4) and overweight group (3.0 months, IQR 3.5; P = 0.024). Reasons given for ceasing breast-feeding in the obese group were maternal complications (29 %), insufficient milk supply (23 %), sucking problems (21 %) and work resumption (21 %). Breast-feeding practice in the total population, but especially among women with obesity, fell short of global WHO recommended standards. Policy initiatives and local interventions should continue to support breast-feeding, but also prevent maternal obesity.
Lee, Kyung Suk; Rha, Yeong-Ho; Oh, In-Hwan; Choi, Yong Sung; Kim, Young-Eun
Purpose There have been conflicting reports concerning the relationship between breast-feeding and the development of atopic dermatitis (AD) in early childhood. The objective of this study was to investigate the associations between breast-feeding and the risk of AD in early childhood in Korea. Methods We combined the fourth and fifth Korea National Health and Nutrition Examination Survey data collected from 2007 to 2012 and analyzed 2,015 children at 1 to 3 years old. Regression analysis was used to determine the association of the following variables: AD, feeding types, duration of breast-feeding, and others. Results The annual prevalence of exclusive breast-feeding and AD decreased. Parents with allergic diseases preferred breast-feeding and extended duration of feeding compared with those without. In multiple logistic regression analyses, exclusive breast-feeding in feeding type I (P=0.070; adjusted odds ratio [OR]=1.990), exclusive breast-feeding in feeding type II (P=0.095; adjusted OR=1.495) and breast-feeding duration (P=0.430; adjusted OR=1.013) were not significantly related to AD. Conclusions Breast-feeding was not found to be associated with an occurrence of AD in young children. Rather, parents with histories of allergic diseases tended to prefer breast-feeding and extend its duration. To clarify the role of breast-feeding in the development of AD, a nation-wide prospective study is needed. PMID:28497917
Lee, Kyung Suk; Rha, Yeong Ho; Oh, In Hwan; Choi, Yong Sung; Kim, Young Eun; Choi, Sun Hee
There have been conflicting reports concerning the relationship between breast-feeding and the development of atopic dermatitis (AD) in early childhood. The objective of this study was to investigate the associations between breast-feeding and the risk of AD in early childhood in Korea. We combined the fourth and fifth Korea National Health and Nutrition Examination Survey data collected from 2007 to 2012 and analyzed 2,015 children at 1 to 3 years old. Regression analysis was used to determine the association of the following variables: AD, feeding types, duration of breast-feeding, and others. The annual prevalence of exclusive breast-feeding and AD decreased. Parents with allergic diseases preferred breast-feeding and extended duration of feeding compared with those without. In multiple logistic regression analyses, exclusive breast-feeding in feeding type I (P=0.070; adjusted odds ratio [OR]=1.990), exclusive breast-feeding in feeding type II (P=0.095; adjusted OR=1.495) and breast-feeding duration (P=0.430; adjusted OR=1.013) were not significantly related to AD. Breast-feeding was not found to be associated with an occurrence of AD in young children. Rather, parents with histories of allergic diseases tended to prefer breast-feeding and extend its duration. To clarify the role of breast-feeding in the development of AD, a nation-wide prospective study is needed.
Koskinen, Katja S; Aho, Anna L; Hannula, Leena; Kaunonen, Marja
to explore the relationship between maternity hospital practices and breast feeding self-efficacy. the data were collected using a cross-sectional survey. The study is a part of a larger longitudinal research and development project called 'Urban parenthood'. three urban maternity hospitals in Southern Finland. altogether 1400 questionnaires were given out and 573 primiparous and multiparous women completed the questionnaire within a week after childbirth. The response rate was 41%. early and successful initiation of breast feeding, rooming-in and exclusive breast feeding during the hospital stay were associated with higher maternal breast feeding self-efficacy in both primiparous and multiparous women. The reason (medical or non-medical), frequency or method (bottle or cup) for supplementation was not associated with breast feeding self-efficacy. breast feeding experiences during the immediate postpartum period have an association with breast feeding self-efficacy. Mothers who are not able to initiate breast feeding within an hour after birth or whose infants are supplemented during the hospital stay may benefit from additional support and breast feeding counselling. Copyright © 2013 Elsevier Ltd. All rights reserved.
Lundberg, Pranee C; Ngoc Thu, Trieu Thi
to describe breast-feeding attitudes and practices among Vietnamese women in Ho Chi Minh City. a descriptive qualitative study was used. The theory of planned behaviour provided the conceptual framework. the Well-baby Clinic, Department of Obstetrics and Gynaecology of a university hospital in Ho Chi Minh City, Vietnam. 23 voluntary Vietnamese mothers. semi-structured in-depth interview with five open-ended questions and observation was used. The interviews were tape-recorded and transcribed verbatim. The data from the interviews and observations were analysed by use of content analysis. five categories of breast-feeding attitudes and practices were identified: breast-feeding best but not exclusive, cultural and traditional beliefs, infant feeding as a learning process, factors influencing decision to breast feed, and intention to feed the child. cultural and traditional beliefs and practices, and socio-economic situation, influenced the Vietnamese mothers' breast feeding. Health-care professionals should consider cultural context and socio-economic issues when preparing infant feeding education and intervention programmes. Appropriate knowledge about cultural values should be included in health-care education in order to provide culturally congruent care to Vietnamese mothers in Vietnam as well as in Western countries. Copyright © 2011 Elsevier Ltd. All rights reserved.
Leahy-Warren, Patricia; Mulcahy, Helen; Phelan, Agnes; Corcoran, Paul
The aim of this research was to identify factors associated with mothers breast feeding and to identify, for those who breast fed, factors associated with breast feeding for as long as planned. breast feeding rates in Ireland are amongst the lowest in Europe. Research evidence indicates that in order for mothers to be successful at breast feeding, multiplicities of supports are necessary for both initiation and duration. The nature of these supports in tandem with other influencing factors requires analysis from an Irish perspective. cross-sectional study involving public health nurses and mothers in Ireland. This paper presents the results of the mothers' evaluation. mothers (n=1715) with children less than three years were offered a choice of completing the self-report questionnaires online or by mail. Data were analysed and reported using descriptive and inferential statistics. four in every five participants breast fed their infant and two thirds of them breast fed as long as planned. The multivariate logistic regression analysis identified that third level education, being a first time mother or previously having breast fed, participating online, having more than two public health nurse visits, and having a positive infant feeding attitude were independently and statistically significantly associated with breast feeding. Among mothers who breast fed, being aged at least 35 years, participating online, having a positive infant feeding attitude and high breast feeding self-efficacy were independently and statistically significantly associated with breast feeding for as long as planned. findings from this study reinforce health inequalities therefore there needs to be a renewed commitment to reducing health inequalities in relation to breast feeding. this study has identified factors associated with initiation and duration of breast feeding that are potentially modifiable through public health interventions. Copyright © 2013 Elsevier Ltd. All rights reserved.
Jordan, S J; Cushing-Haugen, K L; Wicklund, K G; Doherty, J A; Rossing, M A
Evidence suggests that breast-feeding may decrease the risk of epithelial ovarian cancer but it is not clear whether there is a relationship with duration of breast-feeding, patterns of breast-feeding, or particular histological subtypes of ovarian cancer. We sought to investigate these issues in detail. Data from participants in a population-based study of ovarian cancer in western Washington State, USA (2002-2007) who had had at least one birth (881 cases and 1,345 controls) were used to assess relations between patterns of breast-feeding and ovarian cancer. Logistic regression was used to calculate odds ratios (OR) and 95% confidence intervals (CI). Women who ever breast-fed had a 22 % reduction in risk of ovarian cancer compared with those who never breast-fed (OR = 0.78, 95% CI 0.64-0.96) and risk reduction appeared greater with longer durations of feeding per child breast-fed (OR = 0.56, 95% CI 0.32-0.98 for 18 months average duration breast-feeding versus none). Introduction of supplementary feeds did not substantially alter these effects. The overall risk reduction appeared greatest for the endometrioid and clear cell subtypes (OR per month of average breast-feeding per child breast-fed = 0.944, 95% CI 0.903-0.987). Among women who have had the opportunity to breast-feed, ever breast-feeding and increasing durations of episodes of breast-feeding for each breast-fed child are associated with a decrease in the risk of ovarian cancer independent of numbers of births, which may be strongest for the endometrioid subtype.
Jordan, SJ; Cushing-Haugen, KL; Wicklund, KG; Doherty, JA; Rossing, MA
Purpose Evidence suggests that breast feeding may decrease the risk of epithelial ovarian cancer but it is not clear whether there is a relationship with duration of breast feeding, patterns of breast feeding, or particular histological subtypes of ovarian cancer. We sought to investigate these issues in detail. Methods Data from participants in a population-based study of ovarian cancer in western Washington State, USA (2002–2007) who had had at least one birth (881 cases and 1,345 controls) were used to assess relations between patterns of breast feeding and ovarian cancer. Logistic regression was used to calculate odds ratios (OR) and 95% confidence intervals (CI). Results Women who ever breast fed had a 22% reduction in risk of ovarian cancer compared with those who never breast fed (OR=0.78, 95%CI 0.64–0.96) and risk reduction appeared greater with longer durations of feeding per child breast fed (OR=0.56, 95%CI 0.32–0.98 for 18 months average duration breast feeding versus none). Introduction of supplementary feeds did not substantially alter these effects. The overall risk reduction appeared greatest for the endometrioid and clear cell subtypes (OR per month of average breast feeding per child breast fed=0.944, 95%CI 0.903–0.987). Conclusions Amongst women who have had the opportunity to breast feed, ever breast feeding and increasing durations of episodes of breast feeding for each breast-fed child are associated with a decrease in the risk of ovarian cancer independent of numbers of births, which may be strongest for the endometrioid subtype. PMID:22527170
Schwartz, Camille; Chabanet, Claire; Laval, Caroline; Issanchou, Sylvie; Nicklaus, Sophie
Early feeding experiences, e.g. related to milk feeding, can affect later food and taste preferences. However, consequences of breast-feeding on taste acceptance are under-investigated. The objective of the present study was to examine the impact of exclusive breast-feeding duration (DEB) on taste acceptance at 6 and 12 months in the same infants (n 122). Mothers recorded the DEB. Acceptance of solutions of each of the five basic tastes relative to water was evaluated in the laboratory at 6 and 12 months by the ingestion ratio (IR). Kendall correlations were calculated between the DEB and the IR. Only 16 % completed at least 6 months of exclusive breast-feeding; 79 % had begun complementary feeding by 6 months. At 6 months, infants preferred sweet, salty and umami solutions over water and were indifferent to sour and bitter solutions. The longer an infant was breast-fed, the more s/he accepted the umami solution at 6 months. At 12 months, infants preferred sweet and salty solutions over water and were indifferent to sour, bitter and umami solutions. The relationship between the DEB and acceptance of the umami solution was not observed at 12 months. No relationship was observed between the DEB and sweet, salty, sour and bitter taste acceptance at 6 or 12 months. The association between the DEB and umami taste acceptance at 6 months may relate to the higher glutamate content of human milk compared with formula milk. Beyond the acknowledged metabolic benefits of breast-feeding, this suggests that prolonged breast-feeding could also be associated with an impact on sensory preference at the beginning of complementary feeding.
Fewtrell, Mary S
The relationship between breast-feeding and later cardiovascular health has been investigated in randomised trials and observational studies. This review focuses on randomised control trials, regarded as the 'gold standard' in establishing causal relationships between interventions and outcomes. Since it is not ethical to randomise healthy term infants to be breast- or formula-fed, only two randomised control trials have examined effects of breast-feeding on later health. In one randomised control trial, preterm infants randomised to receive banked donor breast milk had significantly lower blood pressure (BP), more favourable plasma lipid profile and reduced leptin resistance at age of 13-15 years compared with those who were fed preterm formula; with a dose-response relationship between the proportion of human milk and later outcomes. In contrast, a cluster-randomised control trial of a breast-feeding promotion intervention in healthy term infants (Promotion of Breast-feeding Intervention Trial study) found no effect of the intervention on adiposity or BP at 6 years, despite increased incidence, duration and exclusivity of breast-feeding. Potential explanations for the discrepancy between the two studies include: (i) beneficial effects of breast milk on cardiovascular health might be confined to preterm infants; (ii) effects on cardiovascular outcomes may not manifest until adolescence, a concept supported by other studies; (iii) if the underlying mechanism for the effect of breast-feeding on later cardiovascular outcome is slower early growth; a concept supported by data from animal models, human observational studies and now experimental studies in human subjects; it is plausible that differences in early growth between groups in the Promotion of Breast-feeding Intervention Trial were insufficient to produce a detectable effect on these outcomes.
Arthur, Chris Rodgers; Saenz, Rebecca B; Replogle, William H
In this study, we examined the personal breast-feeding behaviors of female physicians in Mississippi. Two hundred fifteen of 350 female physicians responded to a survey inquiring of their personal breast-feeding behaviors. One hundred fifty-five mothers (74%) reported having biologic children, and 146 (94.2%) breast-fed at least 1 child. Approximately 21% of the responding mothers breast-fed their first-born children for at least 6 months. There was a positive relationship between the duration of breast-feeding of older children and the breast-feeding duration for younger children. The major reasons for weaning were return to work, diminishing milk supply, and lack of time to pump breast milk. The breast-feeding initiation rates among female physicians surpassed those of women in the general population, yet duration rates were comparable. Their own breast-feeding success might enhance the potential of female physicians as advocates and sources of credible information regarding breast-feeding; however, physicians need to be better educated regarding the management of breast-feeding.
Saarinen, K M; Juntunen-Backman, K; Järvenpää, A L; Klemetti, P; Kuitunen, P; Lope, L; Renlund, M; Siivola, M; Vaarala, O; Savilahti, E
Early feeding with cows' milk (CM) may cause cows' milk allergy (CMA). Breast milk contains many immune factors which compensate for the undeveloped defence mechanisms of the gut of the newborn infant. We studied the effect of supplementary CM feeding at the maternity hospital on the subsequent incidence of CMA, the effects of formula and breast feeding on the subsequent immunologic types of CMA, and the importance of immune factors present in colostrum in the immune responses of infants with CMA. In a cohort of 6209 infants, 824 were exclusively breast-fed and 87% required supplementary milk while in the maternity hospital: 1789 received CM formula, 1859 pasteurized human milk, and 1737 whey hydrolysate formula. The cumulative incidence of CMA, verified by a CM elimination-challenge test, was 2.4% in the CM, 1.7% in the pasteurized human milk and 1.5% in the whey hydrolysate group. Among these infants, exposure to CM at hospital and a positive atopic heredity increased the risk of CMA. Of the exclusively breast-fed infants, 2.1% had CMA. Risk factors for the development of IgE-mediated CMA were: exposure to CM at hospital, breast-feeding during the first 8 weeks at home either exclusively or combined with infrequent exposure to small amounts of CM and long breast-feeding. The content of transforming growth factor-beta1 (TGF-beta1) in colostrum from mothers of infants with IgE-mediated CMA was lower than from mothers of infants with non-IgE-mediated CMA. In infants with CMA, TGF-beta1 in colostrum negatively correlated with the result of skin prick test and the stimulation of peripheral blood mononuclear cells to CM, but positively with infants' IgA and IgG antibodies to CM proteins. Feeding of CM formula at maternity hospital increases the risk of CMA, but exclusive breast-feeding does not eliminate the risk. Prolonged breast-feeding exclusively or combined with infrequent exposure to small amounts of CM during the first 8 weeks induces the development of Ig
Spiby, Helen; McCormick, Felicia; Wallace, Louise; Renfrew, Mary J; D'Souza, Lalitha; Dyson, Lisa
to examine the effects of training, education and practice change interventions with health professionals and lay breast feeding educator/counsellors on duration of breast feeding. this was part of a series of reviews of interventions that affect duration of breast feeding. Full details of methods used, including search strategy, are reported separately. SELECTION CRITERIA FOR INCLUDED STUDIES: randomised controlled trials, non randomised controlled trials with concurrent controls and before after studies (cohort or cross-sectional), undertaken in a developed country, published between 1980 and 2003 in any language. The primary outcome was duration of breast feeding. Secondary and process outcomes, including attitude, knowledge and behaviour change of participants, were included from papers that also reported breast feeding duration outcomes. STUDY-QUALITY ASSESSMENT: inclusion and exclusion criteria were applied, data extracted and study quality assessments made by one reviewer and independently checked by another, with a third reviewer to resolve differences, as recommended by the NHS Centre for Reviews and Dissemination's guidance for reviews. the search identified nine papers. All were before after studies that included the education of health professionals; no studies were identified that related to breast feeding counsellors. In six of the studies, the participants were working with mothers and babies in hospitals (three in the UK, two in Italy and one in France); in three studies, the participants were working in community settings (Canada, Spain and the USA). Two UK studies and two non-UK studies (Spain and USA) involved mothers living in disadvantaged areas. Most interventions aimed to increase knowledge and change professional practice in support of breast feeding. many of the studies reviewed have methodological limitations. Study settings and contexts vary and lack comparability. Evidence from these studies was insufficient to draw conclusions about
Keely, Alice; Lawton, Julia; Swanson, Vivien; Denison, Fiona C
to explore the factors that influence breast-feeding practices in obese women who had either stopped breast-feeding or were no longer exclusively breast-feeding 6-10 weeks following the birth of their babies, despite an original intention to do so for 16 weeks or longer. Specifically (i) to identify the barriers to successful breast-feeding and reasons for introducing formula and/or stopping breast-feeding, and (ii) to explore the women׳s views and experiences of current breast-feeding support services. descriptive, qualitative study comprising semi-structured face-to-face interviews. Interviews were audio recorded and transcribed. The data were analysed using thematic analysis. participants recruited from one large maternity unit in Scotland and interviewed in their homes. 28 obese women at 6-10 weeks following birth. three major themes emerged from the data analysis: the impact of birth complications, a lack of privacy, and a low uptake of specialist breast-feeding support. Impact of birth complications: 19 of 28 women had given birth by caesarean section and some felt this led to feeling 'out of it' post-operatively, a delay in establishing skin-to-skin contact, and in establishing breast-feeding. Lack of privacy; several women described reluctance to breast feed in front of others, difficulties in achieving privacy, in hospital, at home and in public. Low uptake of postnatal breast-feeding support; despite experiencing problems such as physical difficulties during breast-feeding or a perception of low milk supply, breast-feeding support services were underused by this sample of women. A small number of the women in this study used breast-feeding clinics and reported finding these useful. A further small number felt they benefitted from the support of a friend who was successfully breast-feeding. midwives should be mindful of the presence of additional factors alongside maternal obesity, such as caesarean delivery, physical difficulties when breast-feeding
Although breast-feeding receives strong support from physicians, recent focus groups conducted for Health Canada found that it still faces roadblocks because some new mothers find it too embarrassing. In some cases, their male partners oppose breast-feeding. The solution appears to be more and better education provided very early in pregnancy. There is also a need to "spell out explicitly" the role male partners can play in supporting breast-feeding. PMID:8625012
Leeson, C P; Kattenhorn, M; Deanfield, J E; Lucas, A
To test the hypothesis that duration of breast feeding is related to changes in vascular function relevant to the development of cardiovascular disease. Population based observational study. Cambridge. 331 adults (171 women, 160 men) aged between 20 and 28 years, born in Cambridge Maternity Hospital. Distensibility of brachial artery, type and duration of infant feeding, current lipid profile, and other cardiovascular risk factors. The longer the period of breast feeding the less distensible the artery wall in early adult life, with no sex differences (regression coefficient = -3.93 micrometer/month, 95% confidence interval -7.29 to -0.57, P=0.02). However, in those breast fed for less than four months, arterial distensibility was not significantly reduced compared with an exclusively formula fed group. The vascular changes observed were not explained by alterations in plasma cholesterol concentration in adult life. Breast feeding in infancy is related to reduced arterial function 20 years later. These data should not alter current recommendations in favour of breast feeding, which has several benefits for infant health. Further work is needed, however, to explore the optimal duration of breast feeding in relation to cardiovascular outcomes.
Leeson, C P M; Kattenhorn, M; Deanfield, J E; Lucas, A
Objectives To test the hypothesis that duration of breast feeding is related to changes in vascular function relevant to the development of cardiovascular disease. Design Population based observational study. Setting Cambridge. Participants 331 adults (171 women, 160 men) aged between 20 and 28 years, born in Cambridge Maternity Hospital. Main outcome measures Distensibility of brachial artery, type and duration of infant feeding, current lipid profile, and other cardiovascular risk factors. Results The longer the period of breast feeding the less distensible the artery wall in early adult life, with no sex differences (regression coefficient = −3.93 μm/month, 95% confidence interval −7.29 to −0.57, P=0.02). However, in those breast fed for less than four months, arterial distensibility was not significantly reduced compared with an exclusively formula fed group. The vascular changes observed were not explained by alterations in plasma cholesterol concentration in adult life. Conclusions Breast feeding in infancy is related to reduced arterial function 20 years later. These data should not alter current recommendations in favour of breast feeding, which has several benefits for infant health. Further work is needed, however, to explore the optimal duration of breast feeding in relation to cardiovascular outcomes. PMID:11250848
Gunderson, Erica P.
In the general population, breast-feeding is associated with a reduced risk of the offspring being overweight later in life by 22% to 24% across the age spectrum, from preschool children to adults. There is a dose-response gradient with increasing duration of breast-feeding, and lowest risk with prolonged, exclusive breast-feeding. Breast-feeding has been shown to slow infant growth up to 2 years of age. By contrast, the scientific evidence is inconclusive about whether breast-feeding protects against the onset of overweight and subsequent development of type 2 diabetes among offspring whose mothers had diabetes during pregnancy. Moreover, evidence is insufficient to determine if lactation protects against development of type 2 diabetes later in life in women with a diabetes history during pregnancy. Given the paucity of the evidence and equivocal findings about the long-term effects of breast-feeding on future health of women with diabetes during pregnancy and their infants, further research is recommended. PMID:18631440
Gunderson, Erica P
In the general population, breast-feeding is associated with a reduced risk of the offspring being overweight later in life by 22% to 24% across the age spectrum, from preschool children to adults. There is a dose-response gradient with increasing duration of breast-feeding, and lowest risk with prolonged, exclusive breast-feeding. Breast-feeding has been shown to slow infant growth up to 2 years of age. By contrast, the scientific evidence is inconclusive about whether breast-feeding protects against the onset of overweight and subsequent development of type 2 diabetes among offspring whose mothers had diabetes during pregnancy. Moreover, evidence is insufficient to determine if lactation protects against development of type 2 diabetes later in life in women with a diabetes history during pregnancy. Given the paucity of the evidence and equivocal findings about the long-term effects of breast-feeding on future health of women with diabetes during pregnancy and their infants, further research is recommended.
Qu, Pengfei; Wang, Ting; Liu, Fang; Dang, Shaonong; Zeng, Lengxia; Yan, Hong
To determine the breast-feeding pattern of four main ethnic groups (the Han, Uygur, Tibetan and Zhuang) living in rural western China. The study utilized a cross-sectional design. Forty-five counties in ten provinces in western China in 2005. A sample of 11 783 children younger than 36 months old (8960 Han, 1281 Uygur, 792 Tibetan and 750 Zhuang) and their mothers were recruited using a stratified, multistage, cluster random sampling method. The rates of exclusive breast-feeding of children at 6 months of age in the Han, Uygur, Tibetan and Zhuang ethnic groups were 11.6 %, 0.8%, 4.4% and 13.8%, respectively. The rates of any breast-feeding for children at 24 months of age were 8.5%, 25.7%, 3.0% and 4.3% in the four ethnic groups, respectively. After adjusting for related factors, Zhuang children had a higher odds ratio of exclusive breast-feeding to 6 months compared with Han children, whereas Uygur and Tibetan children had lower odds ratio (Zhuang: OR=1.291; 95% CI 1.006, 1.657; Uugur: OR=0.062; 95% CI 0.032, 0.121; Tibetan: OR=0.323; 95% CI 0.220, 0.475). Uygur children had a lower hazard ratio of discontinued breast-feeding compared with Han children, whereas Tibetan children had a higher hazard ratio (Uygur: HR=0.368; 95% CI 0.333, 0.408; Tibetan: HR=1.366; 95% CI 1.244, 1.500). The breast-feeding pattern differed among the Han, Uygur, Tibetan and Zhuang ethnic groups. The results suggest that health education regarding the benefits of breast-feeding is needed in rural western China.
Silfverdal, S A; Ehlin, A; Montgomery, S M
Breast-feeding protects against many infectious diseases and may also influence immunization outcomes. This study investigated if breast-feeding protects against clinical measles and if it modified the effect of immunization. We used logistic regression with data for 10 207 individuals from the 1970 British Cohort study (BCS70). Breast-feeding data were collected at five years of age, and information on clinical measles infection, as well as socio-economic measures was collected at the age of ten years. Breast feeding was categorized as: breast-fed <1 month (n = 1611), breast-fed for 1-3 months (n = 1016), breast-fed for more than three months (n = 1108), breast-feeding of uncertain duration (n = 21) and never breast-fed (n = 6451). Breast-feeding for more than three months was negatively associated with a diagnosis of clinical measles infection after adjustment for crowding, social class, measles vaccination, parity and sex with an odds ratio (95% confidence interval) of 0.69 (0.60-0.81) compared with those who never breast-fed. Measles vaccination was highly associated with low risk for measles with: 0.14 (0.13-0.16). Age at acute measles infection was not associated with breastfeeding. Breast-feeding did not notably alter measles immunization efficacy. Immunization against measles provides effective protection against the disease. A more modest reduction in the risk of a measles diagnosis is associated with breast-feeding. The associations with a diagnosis of measles for breast-feeding and measles immunization are independent of each other.
Mazariegos, Monica; Slater, Christine; Ramirez-Zea, Manuel
Breast-feeding practices (BFPs) can be assessed by interviewing the mother about current feeding practices and with a 24-hour recall. It is crucial to establish the accuracy of these methods, which are commonly used by public health decision makers to design health policies aimed at increasing exclusive breast-feeding rates. We aimed to validate 2 self-report BFP instruments using the dose-to-mother deuterium oxide turnover technique (DMDOT) as the reference method. Breast-feeding practices were assessed by interviewing the mother about current feeding practices and with a 24-hour recall in 36 Guatemalan mother-infant pairs. The validity of these instruments was assessed using DMDOT as the reference method. Both self-report instruments overestimated exclusively breast-fed (EBF) infants. Infants classified as EBF were 50% by the reported current feeding practice, 61% by the 24-hour recall, and only 36% using DMDOT. Sensitivity to detect EBF infants from the mother's self-report was 92% (95% CI: 62%-99%) while from the 24-hour recall was 100% (95% CI: 72%-100%, P < .01). However, specificity for both instruments was low, at 74% (95% CI: 51%-89%) for reported current feeding practice and at 61% (95% CI: 39%-79%) for the 24-hour recall (P < .01). Both reported current feeding practice and the 24-hour recall instruments overestimated exclusive breast-feeding. Nevertheless, the use of reported current feeding practice provided more accurate data to assess BFPs in a public health setting. Furthermore, population-based surveys should consider the overestimation of exclusive breast-feeding caused when using these BFP instruments. © The Author(s) 2016.
Information derived from different anthropological studies carried out in Guatemala as part of the activities of the maternal and child health and nutrition project reveal that, according to popular beliefs, maternal milk plays a definite role in the etiology of diarrheal diseases in the lactating child. This paper presents information on popular classification of diarrheal diseases that differ from biomedical definitions of same. Different factors that may alter the quality of mothers' breast milk and that may cause gastrointestinal diseases in the lactating child are given in detail. The possibilities and limitations of the popular concept frame of "hot-cold", so common in the popular medical beliefs in Latin American populations, are also pointed out as an explanatory model. Lastly, implications of findings in this study are suggested for public health programs, especially for the communication and education programs on breast feeding, and for the application of the high-risk focus.
Ogbo, Felix Akpojene; Page, Andrew; Agho, Kingsley E; Claudio, Fernanda
The present study aimed to examine the trends and differentials in key breast-feeding indicators in Nigeria for the period 1999-2013. Longitudinal study of trends (1999-2013) in optimal feeding practices using a series of population-based Nigerian Demographic and Health Surveys. Trends in socio-economic, health service and individual characteristics associated with key breast-feeding indicators were examined using multilevel regression analyses. Nigeria. Children (n 88 152) aged under 24 months (n 8199 in 1999; n 7620 in 2003; n 33 385 in 2008; n 38 948 in 2013). Among educated mothers, there was an increase in prevalence of exclusive breast-feeding (26% in 1999 to 30% in 2013) and predominant breast-feeding (27% in 1999 to 39% in 2013) compared with mothers with no schooling. A similar increasing trend was evident for mothers from wealthier households and mothers who had a higher frequency of health service access compared with mothers from poorer households and women who reported no health service access, respectively. Mothers with no schooling predominantly breast-fed, but the odds for bottle-feeding were higher among educated mothers and women from wealthier households. The odds for early initiation of breast-feeding were lower for mothers who reported no health service contacts and mothers of lower socio-economic status. Significant increasing trends in key breast-feeding indicators were evident among mothers with higher socio-economic status and mothers who had more health service access in Nigeria. Broader national and sub-national policies that underpin nursing mothers in work environments and a comprehensive community-based approach are proposed to improve feeding practices in Nigeria.
King, F S
The 2 main causes of the contemporary epidemic of breastfeeding failure appear to be urban life and hospital delivery. In rural areas, the majority of mothers breastfeed successfully. They have much emotional support from experienced women around them, and although some women experience problems, traditional birth attendants are skilled at both preventing and overcoming them. In town, a woman may be surrounded only by young friends as inexperienced as herself and a husband who is impatient of a crying infant. The most obvious solution to any difficulty is a feeding bottle which she can see many modern people using, including some health workers. Hospital delivery contributes to lactation failure by separating the mother and baby to allow them both to "rest," yet mothers who are separated from their babies for even 12 hours stop breastfeeding sooner than mothers who put their baby to the breast immediately after delivery. Possibly the emotional bonding that occurs during the 1st few hours gives a mother the motivation that she needs to persist with breastfeeding when it becomes difficult. In most societies it is customary to let the baby breastfeed immediately, and many traditional birth attendants are aware of how this helps both to stop uterine bleeding and to promote a better flow of milk. In hospitals a baby may be given feeds of formula milk or glucose water, while he/she "waits" for mother's milk to come in. Prelacteal feeds fill a baby's stomach, reduce his/her appetite, and make the baby less willing to suck at the breast. This delays the onset of lactation and increases the dangers of engorgement. If a baby is given his/her prelacteal feeds (or later feeds) from a bottle with a rubber teat, he/she is likely to develop "nipple confusion" and to fail to suck effectively from his/her mother. If hospitals are to be places in which babies may start to feed safely, the staff should let a mother suckle her baby immediately after delivery, and they should let her
This study explored the breast-feeding attitudes and beliefs of students newly enrolled in an urban university baccalaureate nursing program. A qualitative approach was used to conduct in-depth semistructured interviews with 12 students prior to their formal course work in maternal-child nursing. Four themes emerged from the data analysis: 1. Personal experiences are important in the development of breast-feeding attitudes and beliefs. 2. The students generally believed that breast-feeding offered benefits for babies and mothers, but the beliefs were stronger for those who grew up with breast-feeding as the norm. 3. All the students believed that there were barriers to breast-feeding in the United States that they identified as the societal view of the breast, dependence/independence conflicts, and concerns about intimacy. 4. The students identified an educational rather than promotional role for nurses in breast-feeding because of conflicts about personal choice. This study suggests that students need help identifying their attitudes and beliefs about breast-feeding and reflecting how their personal experiences influence breast-feeding promotion.
Andersson, Neil; Paredes-Solís, Sergio; Legorreta-Soberanis, José; Cockcroft, Anne; Sherr, Lorraine
To examine changes in breast-feeding and impacts on child health during the Bosnian conflict. Four linked representative cross-sectional household surveys, 1994 to 1997. The countries of former Yugoslavia largely missed the international wave of enthusiasm for breast-feeding of the 1980s and early 1990s. The concern is that breast-feeding deteriorates during humanitarian emergencies, when children need it most. The four surveys visited a random sample of clusters from population registers in the Federation of Bosnia and Herzegovina (BiH) and the Republica Srpska (RS). Interviewers asked about breast-feeding and other factors related to child health, and measured mid upper-arm circumference in 1123 infants aged 1-12 months. One-fifth of infants were not breast-fed at all (220/1087). Muslim and displaced children were less likely to breast-feed; 59 % of Muslim displaced children never breast-fed. Among infants in sites visited by all four surveys, there was no change in the proportion ever breast-fed and a significant increase in duration of breast-feeding and exclusive breast-feeding between 1994 and 1997. Children were breast-fed for shorter durations in male absent households, in frontline communities, the RS, and households that did not receive remittances from abroad. Non-breast-fed children and those who breast-fed for less than 4 months were more likely to be malnourished, as were those with complementary foods added either before or after their sixth month of life. If relief agencies had promoted and supported breast-feeding, this might have avoided some of the increased malnutrition that occurred during the conflict.
Paricio Talayero, J M; Santos Serrano, L; Fernández Feijoo, A; Martí Barranco, E; Bernal Ferrer, A; Ferriol Camacho, M; Sánchez Palomares, M; Lucas Abad, M L
Found sociocultural attitude with regard to breast-feeding (BF) between the sanitary (SP) and no sanitary personnel (NSP) of health centers. Descriptive, cross-sectional study. 4 health centres and 3 hospitals of Valencia. 442 workers of these centres. Structured questionnaire. 88% of SP and 76% of NSP (p < 0.05) believed that BF has many advantages comparing with artificial-feeding in a developed country. SP said more advantages of BF than NSP (p < 0.0001). Most renowned advantages were immunological, affective relationship and comfort. Main inconveniences were dependence, work reasons, aesthetic nature and insecurity in the ingested amount. 56% of SP and 86% of NSP (p < 0.0001) believed milk's analysis necessary. 56% women and 38% men (p < 0.001) didn't see correct give BF in public. Men were more concerned than women (p < 0.05) for local problems of chest, aesthetic results, milk's quality and transmission of illnesses. It's necessary to support knowledge and re-evaluating the trust in the nutritious capacity of maternal milk between the personnel of health centers and hospitals. Generic ambiguity toward functions of feminine breast exists and public'BF isn't acceptable. It's necessary recover socioculturally the image of BF and keep in mind the existent ambiguity upon designing campaigns of promotion.
Rice, P L; Naksook, C
to examine the perceptions and experience of breast-feeding practices among Thai women who are now living in Australia. ethnographic interviews and participant observation among Thai women in Australia. Melbourne Metropolitan Area,Victoria, Australia. Thai women see breast milk as the most valuable food for newborn babies and young children. Breast milk is seen as 'human milk', while infant formula is referred to as 'animal milk'. Breast feeding is seen as beneficial not only to babies' health, but also to the mother's health. Women consume certain foods such as drinking hot water and consuming hot soup during the confinement period as a way to ensure breast milk production. Women appear to know that 'breast is best', but some lack accurate knowledge about breast feeding. They also receive inaccurate information regarding feeding practices from health professionals. there is no doubt that Thai women see that 'breast is best', therefore, the main message for those involved in giving breast-feeding advice is to 'make it easy for women to do it'. Only then can health services and care be made more meaningful to the many women who have decided to breast feed their babies in their new country.
Dorea, José G
Hg and Pb are of public health concern due to their toxic effects on vulnerable fetuses, persistence in pregnant and breast-feeding mothers, and widespread occurrence in the environment. To diminish maternal and infant exposure to Hg and Pb, it is necessary to establish guidelines based on an understanding of the environmental occurrence of these metals and the manner in which they reach the developing human organism. In the present review, environmental exposure, acquisition and storage of these metals via maternal-infant interaction are systematically presented. Though Hg and Pb are dispersed throughout the environment, the risk of exposure to infants is primarily influenced by maternal dietary habits, metal speciation and interaction with nutritional status. Hg and Pb possess similar adverse effects on the central nervous system, but they have environmental and metabolic differences that modulate their toxicity and neurobehavioural outcome in infant exposure during fetal development. Hg is mainly found in protein matrices of animal flesh (especially fish and shellfish), whereas Pb is mainly found in osseous structures. The potential of maternal acquisition is higher and lasts longer for Pb than for Hg. Pb stored in bone has a longer half-life than monomethyl-mercury acquired from fish. Both metals appear in breast milk as a fraction of the levels found in maternal blood supplied to the fetus during gestation. Habitual diets consumed by lactating mothers pose no health hazard to breast-fed infants. Instead, cows' milk-based formulas pose a greater risk of infant exposure to neurotoxic substances.
... page: https://medlineplus.gov/news/fullstory_164308.html Breast-Feeding May Not Lead to Smarter Preschoolers But study ... 27, 2017 MONDAY, March 27, 2017 (HealthDay News) -- Breast-feeding may not make kids sharper or better behaved ...
Batal, Malek; Boulghourjian, Choghik; Abdallah, Ahmad; Afifi, Rima
Breast-feeding (BF) provides the ideal food for the healthy growth and development of infants. The prevalence of BF in Lebanon shows mixed results. The present study was the first large-scale, extensive survey on BF parameters in Lebanon that aimed to explore demographic, socio-economic and other fundamental issues associated with the initiation and duration of BF by Lebanese mothers. The survey was cross-sectional in design and administered over 10 months. Information on all variables was collected from mothers at health centres. Two-stage sampling was conducted to select participants. A total of 1,000 participants were randomly selected. A consent form was provided to each participant. Data were collected from 830 of these. Almost all mothers were Lebanese, married and had given birth in a hospital. About a third stated that breast milk was the first food introduced after birth. Although 55.9% started breast-feeding their newborns within a few hours after birth, and 18.3% within half an hour, 21.2% replied that they initiated BF a few days after birth. Only 4.6% of the mothers replied that they never breast-fed their infant. Timing of initiation of BF was associated with the type of delivery (vaginal/Caesarean section) and hospital-related factors (rooming-in, night feedings and frequency of mother-infant interaction). Of the mothers who breast-fed exclusively beyond 6 months, 86.7% had initiated BF a few hours following delivery, while only 13.3% had initiated BF a few days later. Compared with the exceptionally high proportion of BF initiation, exclusivity of BF was low, dropping to 52.4% at 1 month. Exclusivity of BF was also associated with place of residence (urban/rural) and negatively associated with educational level of the mother. Duration of BF was inversely associated with the use of pain killers during delivery and maternal education. Rural mothers and those who practised exclusive BF maintained BF for a longer duration. Initiation rates of BF are
Liporace, Joyce; Kao, Amy; D'Abreu, Anelyssa
Many women with epilepsy who are planning a pregnancy are treated with lamotrigine (LTG), resulting in greater fetal exposure to the drug. Current care guidelines suggest that mothers with epilepsy breast-feed their children. These recommendations are made without regard to how nursing newborns metabolize medication. Lamotrigine is extensively metabolized by glucuronidation, which is immature in neonates and may lead to accumulation of medication. This article reports LTG levels in full-term nursing newborns born to mothers with epilepsy on lamotrigine monotherapy. Serum LTG levels were obtained in nursing mothers and their neonates on Day 10 of life. Maternal LTG clearance during pregnancy and postpartum was determined and correlated with levels. Four mothers with partial epilepsy on LTG monotherapy were evaluated. Serum LTG levels in nursing newborns ranged from <1.0 to 2.0 microg/mL on Day 10 of life. Three babies had LTG levels >1.0 microg/mL. After excluding one child with an undetectable level, the LTG levels in newborns were on average 30% (range 20-43%) of the maternal drug level. No decline was noted in two children with repeat levels at 2 months. Serum concentrations of LTG in breast-fed children were higher than expected, in some cases reaching "therapeutic" ranges. These high levels may be explained by poor neonatal drug elimination due to inefficient glucuronidation. Our observation that not all newborns had a high LTG level suggests considerable genetic variability in metabolism. Our limited data suggest monitoring blood levels in nursing children and the need for individual counseling for women with epilepsy regarding breast-feeding.
Nichols, Jeni; Schutte, Nicola S.; Brown, Rhonda F.; Dennis, Cindy-Lee; Price, Ian
Maternal self-efficacy for breast-feeding may contribute to success in breast-feeding. This study aimed to increase breast-feeding self-efficacy and actual breast-feeding through an intervention based on Bandura's self-efficacy theory. A total of 90 pregnant women participated in the study. The women who were assigned to a breast-feeding…
Nichols, Jeni; Schutte, Nicola S.; Brown, Rhonda F.; Dennis, Cindy-Lee; Price, Ian
Maternal self-efficacy for breast-feeding may contribute to success in breast-feeding. This study aimed to increase breast-feeding self-efficacy and actual breast-feeding through an intervention based on Bandura's self-efficacy theory. A total of 90 pregnant women participated in the study. The women who were assigned to a breast-feeding…
Hong, Xiumei; Wang, Guoying; Liu, Xin; Kumar, Rajesh; Tsai, Hui-Ju; Arguelles, Lester; Hao, Ke; Pearson, Colleen; Ortiz, Kathryn; Bonzagni, Anthony; Apollon, Stephanie; Fu, Lingling; Caruso, Deanna; Pongracic, Jacqueline A; Schleimer, Robert; Holt, Patrick G; Bauchner, Howard; Wang, Xiaobin
The effect of breast-feeding on the development of allergic disease is uncertain. There are no data that show whether this relationship varies by individual genotypes. We sought to evaluate the effect of breast-feeding and gene-breast-feeding interactions on food sensitization (FS) in a prospective US birth cohort. This study included 970 children who were prospectively followed since birth. Breast-feeding history was obtained from a standardized questionnaire interview. FS was defined as a specific IgE level of 0.35 kU(A)/L or greater to any of 8 common food allergens. Eighty-eight potentially functional single nucleotide polymorphisms (SNPs) were genotyped from 18 genes involved in innate immunity or T(H)1/T(H)2 balance. Logistic regression models were used to test the effects of breast-feeding and gene-breast-feeding interactions on FS, with adjustment for pertinent covariates. Children who were ever breast-fed (n = 739), including exclusively breast-fed children, were at a 1.5 (95% CI, 1.1-2.1; P = .019) times higher risk of FS than never breast-fed children (n = 231). This association was significantly modified by rs425648 in the IL-12 receptor β1 gene (IL12RB1; P for interaction = .0007): breast-feeding increased the risk of FS (odds ratio, 2.0; 95% CI, 1.4-3.1; P = .0005) in children carrying the GG genotype but decreased the risk (odds ratio, 0.6; 95% CI, 0.3-1.4; P = .252) in children carrying the GT/TT genotype. Similar interactions were observed for SNPs in the Toll-like receptor 9 (TLR9; rs352140) and thymic stromal lymphopoietin (TSLP; rs3806933) genes. The interaction between the combined genotypes of the 3 SNPs and breast-feeding on FS was even stronger (P for interaction < 10⁻⁵). Our data suggest that the effect of breast-feeding on FS was modified by SNPs in the IL12RB1, TLR9, and TSLP genes both individually and jointly. Our findings underscore the importance of considering individual genetic variations in assessing this relationship
Breast milk contains hormones, growth factors, cytokines, cells, etc., and offers many advantages over cow's milk or soy protein infant formulae. The composition of breast milk is influenced by gestational and postnatal age. Prevalence of breastfeeding in France is one of the lowest in Europe: in 2003, only 58% of infants were breastfed when leaving the maternity ward, for a median duration of 10 weeks. Breastfeeding allows normal growth until at least 6 months of age, and can be prolonged until the age of 2 years or more, provided that complementary feeding is started after 6 months. Breastfeeding is associated with slightly enhanced performance on tests of cognitive development. Exclusive breastfeeding for at least 3 months is associated with a lower incidence and severity of diarrhoea, otitis media and respiratory infection. Exclusive breastfeeding for at least 6 months is associated with a lower incidence of allergic disease in at-risk infants (infants with at least one first-degree relative presenting with allergy). Breastfeeding is also associated with a lower incidence of obesity during childhood and adolescence, as well as with a lower incidence of hypertension and hypercholesterolemia in adulthood. Maternal infection with hepatitis B and C virus is not a contraindication to breastfeeding, as opposed to HIV infection and galactosemia. A supplementation with vitamin D and K is necessary in the breastfed infant. Very few medications contraindicate breastfeeding. Premature babies can be breastfed and/or receive mother's milk and/or bank milk, provided they receive energy, protein and mineral supplements. Return to prepregnancy weight is earlier in breastfeeding mothers. Breastfeeding is also associated with a decreased risk of breast and ovarian cancer in the premenopausal period, and of hip fractures and osteoporosis in the postmenopausal period.
Swerts, Marlies; Westhof, Ellen; Bogaerts, Annick; Lemiengre, Joke
In 2003 the World Health Organization (WHO) recommended that infants should be fed exclusively with breast milk until the age of six months. However, breast feeding rates remain lower than recommended. The crucial period for breast feeding support is the first two weeks after birth. During this period breast feeding support from the midwife is needed. The aim of this paper is to gain an in-depth understanding of the role of midwives in their support of breast-feeding women, from their own perspective. Two researchers independently conducted a systematic and comprehensive literature search. Studies needed an empirical qualitative research design (1), had to focus on the role of the midwife in the support of the breast-feeding woman from the midwife's perspective (2), and had to be published between January 2005 and December 2014 (3) in order to be included. Language restrictions were English, Dutch, German and French. Eight qualitative research studies were included, using mainly focus group and in-depth interview studies, which were reported in 11 papers representing 231 midwives and 24 maternity nurses. All but one study concerned midwives working in hospital settings. A critical appraisal was performed of each study. Midwives value breast feeding education and breast feeding support as a significant part of their role as a postnatal midwife. However, the ways in which a midwife approaches and supports the breast-feeding woman vary. We distinguished two perspectives: 'the midwife as technical expert' and 'the midwife as a skilled companion'. The 'technical expert' midwife is mainly breast centred, focuses on techniques, uses the hands on approach and sees a woman as a novice. The 'skilled companion' midwife is woman centred, focuses on the mother - infant relationship and uses a hands off approach during the breast feeding support. The midwives working in a hospital setting face many barriers when performing breast feeding support, such as time restraints, which
Yoon, Ji-Won; Park, Young-Joo
The purpose of this study was to measure the effects of a breast feeding promotion program for working women on breast feeding continuation, mother-infant attachment, and maternal sensitivity. The design of this study is nonequivalent control group design with repeated measures. There were significant differences in breast feeding continuation between two groups at each time point except 2 days and 1 week after delivery. The scores of mother-infant attachment and maternal sensitivity of experimental group were higher than those of the control group, but there were no significant differences between two groups. Although some modifications in contents and administration will be required to increase the effectiveness of the program, breast feeding promotion program for working women can be an effective nursing intervention which can facilitate breast feeding continuation and mother-infant relationships.
Viera, Cláudia Silveira
This study is aimed at presenting the 'risk of ineffective breast-feeding' nursing diagnosis regarding mothers of premature infants who are hospitalized in a neonatal Intensive Care Unit. The case study outlined the methodology of the study, and the sample is composed of 35 mothers. Such a diagnosis was detected in 100% of the sample and the risk factors are prematureness; insufficient opportunity to breast-feed due to the newborn's hospitalization; lack of knowledge regarding the maintenance of lactation; maternal fear; inconstancy of breast suction due to separation; and artificial feeding of the newborn. It is believed that the identification of the risks of ineffective breast-feeding during the newborn's hospitalization period makes possible a nursing care focused on the prevention of an 'ineffective breast-feeding' diagnosis.
Briend, André; Wojtyniak, Bogdan; Rowland, Michael G M
The effect of breast feeding on nutritional state, morbidity, and child survival was examined prospectively in a community in rural Bangladesh. Every month for six months health workers inquired about breast feeding and illness and measured arm circumference in an average of 4612 children aged 12-36 months. Data from children who died within one month of a visit were compared with those from children who survived. Roughly one third of the deaths in the age range 18-36 months were attributable to absence of breast feeding. Within this age range protection conferred by breast feeding was independent of age but was evident only in severely malnourished children. In communities with a high prevalence of malnutrition breast feeding may substantially enhance child survival up to 3 years of age. PMID:3129058
Cooke, Margaret; Schmied, Virginia; Sheehan, Athena
To explore the relationships between maternal distress, breast feeding cessation, breast feeding problems and breast feeding maternal role attainment. Longitudinal cohort study. Three urban hospitals within Sydney, Australia. 449 women were invited to participate in the study, with an 81% response rate. Self-report questionnaires were used to collect the data in pregnancy (28-36 weeks) and 2 weeks and 3 months after birth. The Edinburgh Postnatal Depression Scale (EPDS) was used to measure postnatal distress, and the Maternal Role Attainment subscale (MRA) of the Maternal Breast Feeding Evaluation Scale (MBFES) was used to measure breast feeding maternal role attainment. Women with high MRA were less likely to stop breast feeding (even when they had breast feeding problems) than women with low MRA. Antenatal EPDS and anxiety scores were not related to breast feeding cessation or breast feeding problems when analysed alone. As hypothesised, the relationship between breast feeding cessation and postnatal distress (EPDS scores) varied according to MRA level. Women who were categorised as high MRA and no longer breast feeding had higher EPDS scores and were more likely to be categorised as distressed (36%) than women who had low MRA (<12%) or women who had high MRA and continued to breast feed (7%). There is a complex relationship between maternal identity, stopping breast feeding earlier than desired, and psychological distress. Women with strong beliefs about the importance of breast feeding to their maternal role may benefit from psychological assessment and support should they decide to stop breast feeding earlier.
Bueno-Gutierrez, Diana; Chantry, Caroline
Breast-feeding rates reflect sociodemographic discrepancies. In Mexico, exclusive breast-feeding under 6 months of age has deteriorated among the poor, rural and indigenous populations from 1999 to 2012. Our objective of the present study was to identify the main social obstacles to breast-feeding in a low-income population in Tijuana, Mexico. Qualitative study using a socio-ecological framework for data collection. Low-income communities in Tijuana, Mexico. Mothers (n 66), fathers (n 11), grandparents (n 27) and key informants (n 25). One hundred and twenty-nine individuals participated in the study: six focus groups (n 53) and fifty-one interviews among mothers, fathers and grandparents; and twenty-five interviews among key informants. Seven social themes were identified: (i) embarrassment to breast-feed in public; (ii) migrant experience; (iii) women's role in society; (iv) association of formula with higher social status; (v) marketing by the infant food industry; (vi) perception of a non-breast-feeding culture; and (vii) lack of breast-feeding social programmes. Socio-structural factors influence infant feeding practices in low-income communities in Tijuana. We hypothesize that messages emphasizing Mexican traditions along with modern healthy practices could help to re-establish and normalize a breast-feeding culture in this population. The target audience for these messages should not be limited to mothers but also include family, health-care providers, the work environment and society as a whole.
Whitehouse, Andrew J O; Robinson, Monique; Li, Jianghong; Oddy, Wendy H
There is controversy over whether increased breast-feeding duration has long-term benefits for language development. The current study examined whether the positive associations of breast feeding on language ability at age 5 years in the Western Australian Pregnancy (Raine) Cohort, were still present at age 10 years. The Raine Study is a longitudinal study of 2868 liveborn children recruited at approximately 18 weeks gestation. Breast-feeding data were based upon information prospectively collected during infancy, and were summarised according to four categories of breast-feeding duration: (1) never breast-fed, (2) breast-fed predominantly for <4 months, (3) breast-fed predominantly for 4-6 months, and (4) breast-fed predominantly for >6 months. Language ability was assessed in 1195 children at the 10 year follow-up (mean age = 10.58 years; standard deviation = 0.19) using the Peabody Picture Vocabulary Test - Revised (PPVT-R), which is based around a mean of 100 and a standard deviation of 15. Associations between breast-feeding duration and PPVT-R scores were assessed before and after adjustment for a range of sociodemographic, obstetric and psychosocial covariates. Analysis of variance revealed a strong positive association between the duration of predominant breast feeding and PPVT-R at age 10 years. A multivariable linear regression analysis adjusted for covariates and found that children who were predominantly breast-fed for >6 months had a mean PPVT-R score that was 4.04 points higher than children who were never breast-fed. This compared with an increase of 3.56 points at age 5 years. Breast feeding for longer periods in early life has a positive and statistically-independent effect on language development in middle childhood. © 2010 Blackwell Publishing Ltd.
Nitzan Kaluski, D; Leventhal, A
Breast milk is the optimal food for infant growth and development, the prevention of infectious diseases and mother-child bonding. From the economic perspective, breastfeeding is cost-effective both for the family and society as a whole. The Israeli Ministry of Health encourages breastfeeding as the exclusive source of nutrition for infants in the first 4-6 months of life, with gradual addition of complementary foods thereafter. The promotion of breastfeeding in Israel requires comprehensive national activity with involvement of all the stakeholders. This includes implementation of the International Code of Marketing of Breast Milk Substitutes and joining the international "Baby Friendly Hospitals" project. Knowledge of breastfeeding should be spread, health professionals should be encouraged to become agents of change, support by breast counselors should be encouraged, post-delivery vacations from work should be prolonged and empowerment of women implemented.
Jang, Gun-Ja; Kim, Sun-Hee
This study was done to investigate the effects of breast-feeding education and support services on rate of breast-feeding three and six months after birth, and the effect on infant's growth (weight, height, body mass index [BMI]). The experimental group which had both education and support services was compared with the control group which had only breast-feeding education. This study was a quasi-experimental study with a time-series design. The participants were 39 mothers who were hospitalized for childbirth. Twenty mother were assigned to the experimental group and 19 mothers, to the control group. The breast feeding education was done during hospitalization, and support services were provided once a week after discharge for a month (a total 4 times) by a maternity ward nurse. Data regarding breastfeeding rate at one month after childbirth was collected by phone call; the breast-feeding rates at three and six months after childbirth were collected in a visit to the families. The child's weight and height were also measured during the visit. The experimental group had a statistically significant higher rate for frequency of breast-feeding at one, three and six months after childbirth than the control group. However, there was no meaningful difference between the two groups for infant growth. The results of this study suggest that breast-feeding education is helpful for a start, but support services are also necessary to sustain breast-feeding.
Kools, Els J.; Thijs, Carel; de Vries, Hein
The aim of this study was to evaluate the behavioral determinants of the initiation of breast-feeding at birth. The prospective cohort study used the attitude, social influence, self-efficacy (ASE) model in 373 pregnant women in five child health care centers. Prenatally, 72% of the women had the intention to breast-feed, and 73% actually started…
Kools, Els J.; Thijs, Carel; de Vries, Hein
The aim of this study was to evaluate the behavioral determinants of the initiation of breast-feeding at birth. The prospective cohort study used the attitude, social influence, self-efficacy (ASE) model in 373 pregnant women in five child health care centers. Prenatally, 72% of the women had the intention to breast-feed, and 73% actually started…
Pérez-Gil Romo, S E; Rueda Arroniz, F; Ysunza Ogazón, A; Andrade Contreras, M D
The present paper discusses data related to some sociocultural aspects on breast-feeding behavior among a group of women from a rural community in Mexico called Malinalco. A sample of 225 mothers with children aged less than 60 months, was selected. Several home visits were done in order to fill up a questionnaire, as well as to follow direct interviews according to some selected variables to the deepened, such as: schooling, occupation, place of children deliveries, breast-feeding behavior beliefs on breast-feeding abandonment, weaning practices, etc. The results showed that there is no relation between breast-feeding practices, income and school years; nevertheless, there is a certain tendency on early abandonment of breast-feeding in women with higher level of schooling. Some local beliefs about breast-milk production were detected, as well as some remedies to stimulate milk production and to cure certain breast-feeding problems. Data on weaning age and the commonest weaning food products are presented. The importance that cultural dimension has on breast-feeding studies is discussed, as well as the relevance of recognizing "the changes of concepts" within the process of cultural development itself, in order to understand them better and to propose solutions to the generated problems.
Pang, Wei Wei; Bernard, Jonathan Y; Thavamani, Geetha; Chan, Yiong Huak; Fok, Doris; Soh, Shu-E; Chua, Mei Chien; Lim, Sok Bee; Shek, Lynette P; Yap, Fabian; Tan, Kok Hian; Gluckman, Peter D; Godfrey, Keith M; van Dam, Rob M; Kramer, Michael S; Chong, Yap-Seng
Studies examining direct vs. expressed breast milk feeding are scarce. We explored the predictors of mode of breastfeeding and its association with breastfeeding duration in a multi-ethnic Asian population. We included 541 breastfeeding mother-infant pairs from the Growing Up in Singapore Toward healthy Outcomes cohort. Mode of breastfeeding (feeding directly at the breast, expressed breast milk (EBM) feeding only, or mixed feeding (a combination of the former 2 modes)) was ascertained at three months postpartum. Ordinal logistic regression analyses identified predictors of breast milk expression. Cox regression models examined the association between mode of breastfeeding and duration of any and of full breastfeeding. Maternal factors independently associated with a greater likelihood of breast milk expression instead of direct breastfeeding were Chinese (vs. Indian) ethnicity, (adjusted odds ratio, 95% CI; 3.41, 1.97-5.91), tertiary education (vs. secondary education or lower) (2.22, 1.22-4.04), primiparity (1.54, 1.04-2.26) and employment during pregnancy (2.53, 1.60-4.02). Relative to those who fed their infants directly at the breast, mothers who fed their infants EBM only had a higher likelihood of early weaning among all mothers who were breastfeeding (adjusted hazard ratio, 95% CI; 2.20, 1.61-3.02), and among those who were fully breastfeeding (2.39, 1.05-5.41). Mothers who practiced mixed feeding, however, were not at higher risk of earlier termination of any or of full breastfeeding. Mothers who fed their infants EBM exclusively, but not those who practiced mixed feeding, were at a higher risk of terminating breastfeeding earlier than those who fed their infants directly at the breast. More education and support are required for women who feed their infants EBM only.
Pang, Wei Wei; Bernard, Jonathan Y.; Thavamani, Geetha; Chan, Yiong Huak; Fok, Doris; Soh, Shu-E; Chua, Mei Chien; Lim, Sok Bee; Shek, Lynette P.; Yap, Fabian; Tan, Kok Hian; Gluckman, Peter D.; Godfrey, Keith M.; van Dam, Rob M.; Kramer, Michael S.; Chong, Yap-Seng
Background: Studies examining direct vs. expressed breast milk feeding are scarce. We explored the predictors of mode of breastfeeding and its association with breastfeeding duration in a multi-ethnic Asian population. Methods: We included 541 breastfeeding mother—infant pairs from the Growing Up in Singapore Toward healthy Outcomes cohort. Mode of breastfeeding (feeding directly at the breast, expressed breast milk (EBM) feeding only, or mixed feeding (a combination of the former 2 modes)) was ascertained at three months postpartum. Ordinal logistic regression analyses identified predictors of breast milk expression. Cox regression models examined the association between mode of breastfeeding and duration of any and of full breastfeeding. Results: Maternal factors independently associated with a greater likelihood of breast milk expression instead of direct breastfeeding were Chinese (vs. Indian) ethnicity, (adjusted odds ratio, 95% CI; 3.41, 1.97–5.91), tertiary education (vs. secondary education or lower) (2.22, 1.22–4.04), primiparity (1.54, 1.04–2.26) and employment during pregnancy (2.53, 1.60–4.02). Relative to those who fed their infants directly at the breast, mothers who fed their infants EBM only had a higher likelihood of early weaning among all mothers who were breastfeeding (adjusted hazard ratio, 95% CI; 2.20, 1.61–3.02), and among those who were fully breastfeeding (2.39, 1.05–5.41). Mothers who practiced mixed feeding, however, were not at higher risk of earlier termination of any or of full breastfeeding. Conclusions: Mothers who fed their infants EBM exclusively, but not those who practiced mixed feeding, were at a higher risk of terminating breastfeeding earlier than those who fed their infants directly at the breast. More education and support are required for women who feed their infants EBM only. PMID:28554997
Martin, Richard M; Gunnell, David; Owen, Christopher G; Smith, George Davey
It has been suggested that breast milk may play a role in the prevention of certain childhood cancers. We undertook a systematic review of published studies investigating the association between breast-feeding and childhood cancers using Medline (1966 to June 2004), supplemented with auto alerts and manual searches. Analyses are based on odds ratios for specific cancers among those ever breast-fed compared with those never breast-fed, pooled using random-effects models. Forty-nine publications were potentially relevant; of these, 26 provided odds ratio estimates for at least one childhood cancer outcome and were included in metaanalyses. Overall, 92% of the studies were case-control studies, 85% relied on long-term recall of feeding history, only 8% examined breast-feeding exclusivity and control response rates were under 80% in over half. Metaanalyses suggested lower risks associated with having been breast-fed of 9% (95% CI = 2-16%) for acute lymphoblastic leukemia, 24% (3-40%) for Hodgkin's disease and 41% (22-56%) for neuroblastoma, with little between-study heterogeneity. The estimates for Hodgkin's disease and neuroblastoma, however, were driven by single studies. There was little evidence that breast-feeding was associated with acute nonlymphoblastic leukemia, non-Hodgkin's lymphoma, central nervous system cancers, malignant germ cell tumors, juvenile bone tumors, or other solid cancers. In conclusion, ever having been breast-fed is inversely associated with acute lymphoblastic leukemia, Hodgkin's disease and neuroblastoma in childhood, but noncausal explanations are possible. Even if causal, the public health importance of these associations may be small. Our estimates suggest that increasing breast-feeding from 50% to 100% would prevent at most 5% of cases of childhood acute leukemia or lymphoma. (c) 2005 Wiley-Liss, Inc.
Murila, Florence; Obimbo, Moses M; Musoke, Rachel; Tsikhutsu, Isaac; Migiro, Santau; Ogeng'o, Julius
In Kenya, human immunodeficiency virus (HIV) prevalence ranks among the highest in the world. Approximately 60 000 infections yearly are attributed to vertical transmission including the process of labour and breast-feeding. The vast of the population affected is in the developing world. Clinical officers and nurses play an important role in provision of primary health care to antenatal and postnatal mothers. There are a few studies that have explored the clinicians' knowledge on breast-feeding in the face of HIV and in relation to vertical transmission this being a vital component in prevention of maternal-to-child transmission. The aim of this study was to evaluate clinicians' knowledge on HIV in relation to breast-feeding in Kenya. A cross-sectional survey was conducted to assess knowledge of 161 clinical officers and nurses serving in the maternity and children' wards in various hospitals in Kenya. The participants were derived from all district and provincial referral facilities in Kenya. A preformatted questionnaire containing a series of questions on HIV and breast-feeding was administered to clinicians who were then scored and analyzed. All the 161 participants responded. Majority of clinicians (92%) were knowledgeable regarding prevention of mother-to-child transmission. Regarding HIV and breast-feeding, 49.7% thought expressed breast milk from HIV-positive mothers should be heated before being given. Majority (78.3%) thought breast milk should be given regardless of availability of alternatives. According to 74.5% of the participants, exclusive breast-feeding increased chances of HIV transmission. Two-thirds (66.5%) would recommend breast-feeding for mothers who do not know their HIV status (66.5%). This study observes that a majority of the clinicians have inadequate knowledge on breast-feeding in the face of HIV. There is need to promote training programmes on breast-feeding and transmission of HIV from mother to child. This can be done as in
Ando, Hitoshi; Matsubara, Shigeki; Oi, Asako; Usui, Rie; Suzuki, Mitsuaki; Fujimura, Akio
Zonisamide, an antiepileptic drug, is excreted into breast milk, but information regarding the safety of breast-feeding while using this drug is limited. We present the cases of two nursing mothers, taking 300 and 100 mg/day zonisamide. At 5 days after delivery, the milk concentrations and relative infant doses of the drug were 18.0 and 5.1 μg/mL, and 44 and 36%, respectively. In the first case, the mother fed colostrum and continued partial breast-feeding thus reducing the relative infant dose to 8%. The neonatal serum concentration of zonisamide declined to below the limit of detection at day 34 after birth. In the second case, the mother breast-fed partially until 2 weeks postpartum. No adverse effect was observed in the infants. These findings suggest that mothers taking zonisamide should not breast-feed exclusively, but may not have to avoid partial breast-feeding, with significant caution regarding adverse effects in infants. © 2013 The Authors. Journal of Obstetrics and Gynaecology Research © 2013 Japan Society of Obstetrics and Gynecology.
Bhargava, S K
Recent information on breastfeeding has confirmed almost all the facts and beliefs known for centuries about mother's milk, i.e., it protects an infant and helps him/her grow optimally both physically and emotionally. Yet, no other child health promotional effort has been threatened in recent times as the practice of breastfeeding. It is not uncommon to find both rural and urban mothers who believe that infants fed on formula grow to be bonnier and healthier. Coupled with this belief is often their feeling that is is difficult to introduce semisolids, solids and top milk to an infant if the infant is unaccustomed to a bottle or a commercially available infant food in earlier weeks of life. 1 reason for this situation is the publicity blitz aimed at promotion of commercially available infant foods and the feeding bottle. In contrast to the aggressive promotion of formula feeding, there is a lack of information on breastfeeding and its promotion through the mass media. There is no food which has been invented to replace the mother's love or its suitability in terms of a child's physiological, nutritional, and emotional needs. The mammary gland allows mammals to nurture their offspring with their own milk, milk that is constituted in such a way that it optimally meets the needs of the offspring. This is evident from the comparison of milk from human and various animal sources. Each animal produces milk which is best suited for its survival and growth and which vastly differs from human milk. Breast milk is richer in carbohydrates, qualitatively superior in proteins and minerals, and is low in solute load. It is thus easily digestible by infants whether of low or normal birth weight or premature. Milk from animal sources is unsuitable for infants in the 1st few weeks. At least in terms of composition, breast milk is the most suitable milk among all the available milk for infants. It does not need money for purchase, fuel for warming, water for dilution, and
Sussner, Katarina M; Lindsay, Ana C; Peterson, Karen E
While the 'immigrant health paradox' posits better health behaviours and outcomes for immigrants upon arrival to the US, research suggests that this advantage may deteriorate over time. This study analysed the relationship of acculturation and breast-feeding initiation and duration among a sample of predominantly Latina, low-income women in the US. The four measures of acculturation included: mother's nativity (foreign born vs US born), mother's parents' nativity (foreign born vs US born), years of US residence (<8 years vs > or =8 years) and a dichotomous measure of language acculturation adapted from three items on Marin's acculturation scale (preferred language spoken at home, reading language and writing language) as exclusive use of native language versus non-exclusive use (mixed or English only) (Marin et al., 1987; Marin & Gamba, 1996). Final multivariable models showed that mothers who exclusively used their native language were more likely to initiate breast-feeding as well as breast-feed for longer duration compared with mothers with non-exclusive use, whereas years of US residence and mother's nativity were not significantly associated with breast-feeding initiation or duration. Mother's parents' nativity also emerged as a significant predictor of breast-feeding duration, both within final models for immigrants and across study participants. Programmes providing nutrition education to low-income women may wish to consider the role of language as an important determinant of breast-feeding. The role of mother's parents' nativity on breast-feeding practices deserves exploration in future studies, as the cultural practices taught by family members born outside the US may exert strong pressure within immigrant families now living in the US.
Magnus, P D; Frantz, K D
In his paper of March 10 (p.541), Dr. Davies, not for the 1st time, misrepresents our ideas on assisting the mother and her infant to preserve lactation as an exclusive form of nurturing. Citing us, Davies states that: "A view has been expressed that drawing attention to the failure of breastfeeding will not help to encourage breastfeeding." All we say is that healthcare workers should be loath to label an infant who fails to thrive as a product of inadequate lactation without observing the breastfeeding process. Davies does not mention that some poor gainers have sucking defects; we have noted problems such as tongue sucking, flutter sucking (rapid and weak motions), and a lack of drawing the nipple far enough into the mouth (baby falls off breast easily). However we do agree with most of Davies' comments for diagnosis and treatment and commend him for his preventive approach to the impediments of lactation based on the community healthworker. We doubt if we could give the naturally nervous baby who is a difficult feeder 30-60 mg of chloral hydrate as he suggests. While we do not have the answers for all of the psychosocial problems which may interfere with lactation, there is another measure which can be instituted if all of Davies' approaches fail. By introducing complementary total bottlefeeding to make the baby thrive, you introduce the mechanical problem of nipple confusion and may make exclusive breastfeeding even less likely. For infants who are small for gestational age, premature, have sucking defects, or fail to thrive (without organic disease) and whose mothers wish to continue with human milk, we use a device called the Lact-Aid Supplementer (J.J. Avery, Inc., Denver). This gives additional milk (and calories) and corrects most abnormalities in sucking patterns without the use of a bottle. The availability of early well-baby or lactation clinics at 10-14 days postpartum would provide reassurance and counseling to the mother. When there is true failure
Kwok, Man Ki; Leung, Gabriel M; Schooling, C Mary
Breast feeding may contribute to neurological development and hence mental health. However, associations from Western populations are unclear, and most likely confounded by socioeconomic position (SEP), making evidence from other sociocultural settings valuable. We examined whether breast feeding was associated with early adolescent emotional and behavioural problems, self-esteem and depressive symptoms in a non-Western developed setting, where socioeconomic patterning of breast feeding differs from but other postnatal characteristics are similar to Western settings. The adjusted associations of breast feeding with emotional and behavioural problems assessed from parent-reported Rutter z-score at ~11 years (n=5598, 67% follow-up), self-reported self-esteem z-score at ~11 years (n=6937, 84%) and depressive symptoms assessed from self-reported Patient Health Questionnaire-9 z-score at ~13 years (n=5797, 70%) were examined using multivariable linear regression in a population-representative Hong Kong Chinese birth cohort, 'Children of 1997'. Mothers from families with higher education tended to start but not sustain breast feeding, whereas migrant mothers tended to start and sustain breast feeding. Breast feeding for 3+ months had mostly null associations with Rutter score, self-esteem or depressive symptoms adjusted for sex, age, survey mode, SEP, parents' age, birth weight-for-gestational age, birth order and secondhand smoke exposure, although partial breast feeding for any length of time or exclusive breast feeding for <3 months was associated with poorer behaviour (higher Rutter z-score (0.10, 95% CI 0.05 to 0.16)) and lower self-esteem (-0.09, 95% CI -0.14 to -0.04). In a non-Western developed setting, breast feeding was inconsistently associated with several early adolescent mental health measures suggesting a reflection of setting specific unmeasured confounding.
Radwan, Hadia; Mussaiger, Abdulrahman O; Hachem, Fatima
This study was designed to investigate the relation of breast-feeding and weaning practices with the duration of lactational amenorrhea among breast-feeding mothers in the United Arab Emirates. A total of 593 mothers were interviewed in the Maternal and Child Health Centers in three areas: Abu Dhabi, Dubai, and Al Ain. The total mean duration of lactational amenorrhea in this study was 6.1 months, and there was a direct relation with the length of exclusive breast-feeding. The duration of postpartum amenorrhea was the longest in Al Ain (7.2 months), as compared with Dubai (6.9 months) and Abu Dhabi (4.3 months). The age of the infant when formula milk and solid supplements were introduced was significantly related to the duration of lactational amenorrhea. This study confirms the results of other studies concerning the effectiveness of the lactational amenorrhea method as a natural method of contraception for the first 6 months postpartum, especially for mothers who breast-feed exclusively and more frequently and who delay the introduction of food supplements.
Alm, B; Wennergren, G; Norvenius, S; Skjaerven, R; Lagercrantz, H; Helweg-Larsen, K; Irgens, L
Aims: To assess the effects of breast feeding habits on sudden infant death syndrome (SIDS). Methods: The analyses are based on data from the Nordic Epidemiological SIDS Study, a case–control study in which parents of SIDS victims in the Scandinavian countries between 1 September 1992 and 31 August 1995 were invited to participate, each with parents of four matched controls. The odds ratios presented were computed by conditional logistic regression analysis. Results: After adjustment for smoking during pregnancy, paternal employment, sleeping position, and age of the infant, the adjusted odds ratio (95% CI) was 5.1 (2.3 to 11.2) if the infant was exclusively breast fed for less than four weeks, 3.7 (1.6 to 8.4) for 4–7 weeks, 1.6 (0.7 to 3.6) for 8–11 weeks, and 2.8 (1.2 to 6.8) for 12–15 weeks, with exclusive breast feeding over 16 weeks as the reference. Mixed feeding in the first week post partum did not increase the risk. Conclusions: The study is supportive of a weak relation between breast feeding and SIDS reduction. PMID:12023166
Thoman, Evelyn B.; And Others
Using a modified time-sampling procedure, 20 primiparous and 20 multiparous mothers were observed while breast-feeding their 48-hour old infants. In comparison with multiparous mothers, primiparous mothers (1) spend more time in non-feeding activities, (2) spend more time feeding male infants, (3) change activity more frequently, (4) provide more…
Tobback, Els; Behaeghel, Katoesjka; Hanoulle, Ignace; Delesie, Liesbeth; Loccufier, Anne; Van Holsbeeck, Ann; Vogelaers, Dirk; Mariman, An
Artificial milk supplementation remains a popular practice in spite of the well documented and indisputable advantages of breast feeding for both mother and child. However, the association between maternal sleep, fatigue and feeding method is understudied and remains unclear. The aim of this study is to investigate whether perceived sleep and fatigue differ between breast- and bottle feeding post partum women. In addition, the relationship between subjective sleep characteristics and fatigue is examined. Post partum women (four to 16 weeks) filled out a socio-demographic questionnaire, the Pittsburgh Sleep Quality Index (PSQI) and the Checklist Individual Strength (CIS). Sixty-one within the past week exclusively breast- and 44 exclusively bottle-feeding mothers were included. The first group showed better subjective sleep quality, but lower habitual sleep efficiency as measured by the PSQI. Global PSQI, as well as subjective fatigue and global CIS, did not differ between the two groups. Significant positive correlations were found between global CIS and the number of night feeds and global PSQI. However, only global PSQI significantly predicted global CIS in relation to the number of night feeds. Within a general pattern of deteriorated sleep quality, breast-feeding women showed better subjective sleep quality, but lower habitual sleep efficiency, between four and fourteen weeks after childbirth. However, the PSQI component scores compensated for each other, resulting in absence of any difference in global PSQI sleep quality between the two groups. Global PSQI significantly predicted global CIS, resulting in an absence of any difference in post partum fatigue according to feeding method. Midwives and nurses should, together with the parents, continue to focus on exploring ways to improve maternal sleep quality and to reduce postnatal fatigue. Copyright © 2017 Elsevier Ltd. All rights reserved.
Grewal, Navnit Kaur; Andersen, Lene Frost; Sellen, Daniel; Mosdøl, Annhild; Torheim, Liv Elin
To examine breast-feeding and complementary feeding practices during the first 6 months of life among Norwegian infants of Somali and Iraqi family origin. A cross-sectional survey was performed during March 2013-February 2014. Data were collected using a semi-quantitative FFQ adapted from the second Norwegian national dietary survey among infants in 2006-2007. Somali-born and Iraqi-born mothers living in eastern Norway were invited to participate. One hundred and seven mothers/infants of Somali origin and eighty mothers/infants of Iraqi origin participated. Breast-feeding was almost universally initiated after birth. Only 7 % of Norwegian-Somali and 10 % of Norwegian-Iraqi infants were exclusively breast-fed at 4 months of age. By 1 month of age, water had been introduced to 30 % of Norwegian-Somali and 26 % of Norwegian-Iraqi infants, and infant formula to 44 % and 34 %, respectively. Fifty-four per cent of Norwegian-Somali and 68 % of Norwegian-Iraqi infants had been introduced to solid or semi-solid foods at 4 months of age. Breast-feeding at 6 months of age was more common among Norwegian-Somali infants (79 %) compared with Norwegian-Iraqi infants (58 %; P=0·001). Multivariate analyses indicated no significant factors associated with exclusive breast-feeding at 3·5 months of age. Factors positively associated with breast-feeding at 6 months were country of origin (Somalia) and parity (>2). Breast-feeding initiation was common among Iraqi-born and Somali-born mothers, but the exclusive breast-feeding period was shorter than recommended in both groups. The study suggests that there is a need for new culture-specific approaches to support exclusive breast-feeding and complementary feeding practices among foreign-born mothers living in Norway.
Wingard, D L; Criqui, M H; Edelstein, S L; Tucker, J; Tomlinson-Keasey, C; Schwartz, J E; Friedman, H S
The purpose of the study was to determine whether breast-feeding is associated with increased longevity or cause-specific survival. Teachers throughout California identified intellectually gifted children as part of a prospective study begun in the 1920s by Lewis Terman. Information on breast-feeding was available on 1170 subjects, who have been followed for more than 65 years. Survival analysis (Cox proportional hazards model) indicated that breast-feeding was associated with increased longevity, even after adjustment for age at baseline, birthweight, infant health, and childhood socioeconomic status, but only among men, and the association was not significant (P = .15). Neither cardiovascular disease nor cancer survival was significantly associated with duration of breast-feeding for either sex. Survival from deaths due to injuries was positively associated with breast-feeding after adjustment (P = .03) and demonstrated a clear gradient with duration, but only among men. Overall, the present study does not provide strong evidence that breast-feeding is associated with adult longevity. The reduced risk of death from injury may reflect chance, in that the association was significant only for men, or it may reflect psychosocial correlates of breast-feeding practices.
Wingard, D L; Criqui, M H; Edelstein, S L; Tucker, J; Tomlinson-Keasey, C; Schwartz, J E; Friedman, H S
OBJECTIVES. The purpose of the study was to determine whether breast-feeding is associated with increased longevity or cause-specific survival. METHODS. Teachers throughout California identified intellectually gifted children as part of a prospective study begun in the 1920s by Lewis Terman. Information on breast-feeding was available on 1170 subjects, who have been followed for more than 65 years. RESULTS. Survival analysis (Cox proportional hazards model) indicated that breast-feeding was associated with increased longevity, even after adjustment for age at baseline, birthweight, infant health, and childhood socioeconomic status, but only among men, and the association was not significant (P = .15). Neither cardiovascular disease nor cancer survival was significantly associated with duration of breast-feeding for either sex. Survival from deaths due to injuries was positively associated with breast-feeding after adjustment (P = .03) and demonstrated a clear gradient with duration, but only among men. CONCLUSIONS. Overall, the present study does not provide strong evidence that breast-feeding is associated with adult longevity. The reduced risk of death from injury may reflect chance, in that the association was significant only for men, or it may reflect psychosocial correlates of breast-feeding practices. PMID:8092371
Novotny, R; Kieffer, E C; Mor, J; Thiele, M; Nikaido, M
To determine factors influencing infant feeding method choices among women who received services from the Special Supplemental Food Program for Women, Infants, and Children (WIC) during pregnancy in Hawaii. A retrospective survey mailed to all resident mothers who had live births in Hawaii between January 1, 1989, and March 31, 1989, and who received WIC services during pregnancy. The state of Hawaii. The subjects were 322 mothers who received WIC services during pregnancy for whom data were complete, taken from a sample of 2,013 women who had live births in the state of Hawaii (51% response rate) between January 1, 1989, and March 31, 1989, of whom 324 participated in WIC during pregnancy. Infant feeding method (exclusive breast, exclusive formula or mixed) at hospital discharge. The chi 2 analysis for differences among feeding method groups and multiple logistic regression to calculate odds ratios for independent effects of maternal characteristics and other influences on feeding method choice. Reasons for infant feeding choice, timing of the choice, maternal age, parity, and place of residence were the main factor influencing infant method choice. Health of the infant was the primary reason for choice of feeding method and was the strongest determinant of exclusive breast-feeding (odds ratio = 23.99; confidence interval = 9.75-59.02; P < .0001) and was negatively related to the choice to formula-feed (odds ratio = 0.03; confidence interval = 0.01-0.08; P < .0001). Relationship between WIC and hospital lactation consultants could enhance follow up in the hospital and after returning home with WIC mothers who prenatally state an intention to breast-feed. Convenience and bonding are aspects of breast-feeding enjoyed by WIC mothers in Hawaii that could be used in breast-feeding promotion efforts.
de Aquino, Rebeca Raposo; Osório, Mônica Maria
The transition from tube feeding to exclusive breastfeeding represents an important period for preterm babies because of their clinical fragility and immature development. This study describes this transition in preterm infants in relation to different feeding approaches: relactation, translactation, and breast-orogastric (OG) tube, considering the duration of the transition, weight gain in the transition, feeding-related problems, and breastfeeding status at discharge. This is a descriptive study of a series of 432 babies using retrospective data from the medical records at the IMIP Kangaroo Mother Care Unit, in the northeast of Brazil. At discharge, the percentage of babies who were exclusively breastfed in the relactation, translactation, and breast-OG tube groups were 85%, 100%, and 100%, respectively, with a satisfactory transition time and weight gain and with 1.6% of cases with feeding-related problems. The results showed that the relactation, translactation, and breast-OG tube seem to be efficient methods in the feeding transition of preterm infants.
Crowell, M K; Hill, P D; Humenick, S S
The Infant Breast-feeding Assessment Tool (IBFAT) was used to assess the time of effective breast feeding in 48 healthy term infants born to mothers having their first or second baby. Infants of mothers who received an analgesia (butorphanol or nalbuphine) in labor (n = 26) were compared with infants whose mothers did not receive any labor analgesia (n = 22). Timing of the administration of labor analgesia was also examined with infants whose mothers received no analgesia or analgesia within an hour of birth compared with infants whose mothers received analgesia more than one hour before birth. Infants of first-time breast-feeding mothers took longer to establish effective feeding compared with infants of second-time breast-feeding mothers. Male infants also took longer. Labor analgesia significantly affected mother-rated IBFAT scores when initiation time was considered. Infants who received analgesia within an hour of birth, or no analgesia, and who initiated breast feeding early, established effective feeding significantly earlier than infants with longer duration of analgesia and later initiation of breast feeding.
Noble, Lawrence; Hand, Ivan; Haynes, Diane; McVeigh, Tammy; Kim, MaeHee; Yoon, Jing Ja
The objective of our study was to identify factors associated with the initiation of breast-feeding in a poor urban area. One hundred postpartum, nonadolescent, non-drug using mothers, 50 breast-feeding and 50 formula feeding, were consecutively interviewed. Breast-feeding women were more likely to be born outside of the United States (42 versus 14%, p = 0.002), have more years of education (12.1 +/- 1.9 versus 10.9 +/- 1.7, p = 0.002), be employed either prior to or during pregnancy (38 versus 16%, p = 0.000), be married (46 versus 26%, p = 0.037), be a nonsmoker (86 versus 64%, p = 0.011), have more prenatal visits (8.4 +/- 7.3 versus 5.0 +/- 5.9, p = 0.010), or have a breast-feeding mother (48 versus 26%, p = 0.023). There were no differences in age or ethnicity. The father of the breast-feeding baby was more likely to be better educated (12.0 +/- 2.8 versus 10.5 +/- 3.6 years, p = 0.022) and to work full-time (68 versus 40%, p = 0.005). Eighty-four percent of formula feeders knew that breast milk was better for their babies but decided not to breast-feed due to concerns of pain, smoking, and work. Sixty-three percent of women made the choice to breast-feed prior to the pregnancy, 26% during the pregnancy, and 11% after delivery. Significantly more multiparas decided prior to the pregnancy compared with primaparas. We recommend that breast-feeding education should be started prior to the first pregnancy and tailored to the concerns of the women.
Hasselbalch, H; Engelmann, M D; Ersboll, A K; Jeppesen, D L; Fleischer-Michaelsen, K
We have previously shown that breast-fed infants have a considerably larger thymus at 4 months than formula-fed infants. The aim of the present study was to investigate whether breast-feeding also influences the thymic size in late infancy. In a cohort of 50 infants, all being partially breast-fed when recruited at 8 months, ultrasound assessment of the thymic index (a volume estimate) was performed at both 8 and 10 months of age. At 10 months the thymic index was significantly higher in those still being breast-fed compared to infants who had stopped breast-feeding between 8 and 10 months of age (P=0.05). This difference became more significant when controlled for the influence of infectious diseases (P=0.03). In infants still breast-fed at 10 months there was a significant correlation between the number of breast-feeds per day and their thymic index (P=0.01). Conclusion The effect of breast-feeding on thymus size is likely to be caused by immune modulating factors in breast milk. Breast milk influences thymic size in late infancy.
Kull, Inger; Melen, Erik; Alm, Johan; Hallberg, Jenny; Svartengren, Magnus; van Hage, Marianne; Pershagen, Göran; Wickman, Magnus; Bergström, Anna
The evidence from previous studies on beneficial effects of breast-feeding in relation to development of asthma is conflicting. To investigate the relation between breast-feeding and asthma and/or sensitization during the first 8 years of life. In a birth cohort, children were followed up to 8 years by questionnaires at ages 2 months and 1, 2, 4, and 8 years to collect information on exposures and health effects. Determination of serum IgE antibodies to common inhalant and food allergens was performed at 4 and 8 years. Longitudinal analyses were applied by using general estimated equations. The study population consisted of 3825 children (93% of the original cohort), of whom 2370 gave blood and 2564 performed lung function measurements at 8 years. Children exclusively breast-fed 4 months or more had a reduced risk of asthma during the first 8 years of life (adjusted odds ratio [OR], 0.63; 95% CI, 0.50-0.78) compared with children breast-fed less than 4 months. At 8 years, reduced risks of sensitization (adjusted OR, 0.79; 95% CI, 0.64-0.99) and asthma in combination with sensitization (adjusted OR, 0.59; 95% CI, 0.37-0.93) were seen among children exclusively breast-fed 4 months or more. This group also had a significantly better lung function measured with peak expiratory flow. Breast-feeding for 4 months or more seems to reduce the risk of asthma up to 8 years. At this age, a reduced risk was observed particularly for asthma combined with sensitization. Furthermore, breast-feeding seems to have a beneficial effect on lung function. Copyright 2010 American Academy of Allergy, Asthma & Immunology. Published by Mosby, Inc. All rights reserved.
Infant feeding patterns in Malaysia were assessed using data obtained by interviewing 5160 women who gave birth to 8755 babies in 3 urban areas and 6 rural areas from 1970-1974. The study was undertaken in an effort to determine appropriate strategies for promoting breast-feeding. 64.2% of the 8755 were breast-fed. Considerable variation in breast-feeding patterns was observed when the data was analyzed in reference to ethnic affiliation, residence, family income, and mother's educational level. While 88.9% of the Malay infants were breast-fed, only 69.7% of the Indian infants and 42.3% of the Chinese infants were breast-fed. 47.0% of the infants in urban areas were breast-fed compared to 77.5% in the rural areas. Women in higher income and educational groupings were less likely to breast-feed their children than women in lower income and educational groupings. In the urban areas, approximately 1/2 of the Malay women, 1/2 of the Indian women, and 2/3 of the Chinese women discontinued breast-feeding before their children were 3 months old. Chinese women who delivered in private hospitals were less likely to breast-feed their infants than those who delivered in government hospitals. Among rural Malay women, those who delivered in hospitals were less likely to breast-feed than those who delivered at home. The findings suggested that 1) hospital personnel, especially those who work in private hospitals, should take a more active role in promoting lactation; 2) health personnel and mothers need to be more adequately informed about the advantages of breast-feeding; 3) women in higher income and educational groups should be encouraged to breast-feed since they serve as role models for women in the lower income and educational groups; and 4) additional studies should be undertaken in order to identify those cultural attitudes which inhibit lactation among Chinese women. Tables showed 1) the number and % distribution of breast-feeding and 2) the % of infants breast-fed by
Eickmann, Sophie Helena; de Lira, Pedro Israel Cabral; Lima, Marilia de Carvalho; Coutinho, Sonia Bechara; Teixeira, Maria de Lourdes Perez Diaz; Ashworth, Ann
The aim of this prospective study was to investigate the association between breast feeding and mental and motor development at age 12 months, controlling for comprehensive measures of the child's socio-economic, maternal and environmental background, and nutritional status. A cohort of 205 infants born during May-August 2001 in a poor area in the interior of the State of Pernambuco was enrolled, of whom 191 were tested at age 12 months with the Bayley Scales of Infant Development II, and in whom breast-feeding status was measured at days 1, 10, 30, 60, 90, 120, 150, 180, 270 and 360. After adjusting for potential confounders, full breast feeding (i.e. exclusive or predominant) at 1 month was associated with a small but significant benefit in mental development (+3.0 points, P = 0.02) compared with partial or no breast feeding. No additional advantage in mental development was found with longer durations of full breast feeding. Full breast feeding at 1 month was associated with improved behaviour for two of 10 ratings tested: initiative with tasks (P = 0.003) and attention (P = 0.02). No association between breast feeding and motor development was found.
Huang, Li-Li; Xiong, Fei; Yang, Fan
To study the effect of breast milk composition on weight growth velocity of infants fed with exclusive breast milk. One hundred and thirty-eight full-term singleton infants who received regular follow-up visits and fed with exclusive breast milk and their mothers were recruited. Body height, weight and head circumference of these infants were measured at regular visits. Z scores were used to evaluate growth velocity. The subjects were classified into a failure to thrive group (ΔZ scores≤-0.67), a poor growth group (-0.67<ΔZ scores<0) and a normal control group (ΔZ scores≥0). The samples of mature breast milk were collected for composition analysis. The differences in the levels of the protein, fats, energy, carbohydrates and minerals in breast milk were compared among the three groups. ΔZ scores for weight in the failure to thrive and poor growth groups were lower than in the normal control group (P<0.05). There was no significant difference in the levels of protein, fats and energy in breast milk among the failure to thrive, poor growth and normal control groups. However, the levels of carbohydrates and minerals in both the failure to thrive and poor growth groups were lower than in the normal control group (P<0.05). Weight growth velocity of infants can be affected by the composition of breast milk to a certain degree in a short period. In order to maintain a good weight growth velocity of infants, mothers should have a balanced diet to improve the quality of breast milk.
Yurdakök, Kadriye; Temiz, Fatih; Yalçin, S Songül; Gümrük, Fatma
Iron deficiency anemia (IDA) remains the most prevalent nutritional deficiency in infants worldwide. The purpose of this study was to determine the efficacy of daily and weekly iron supplementation for 3 months to improve the iron status in 4-month-old, exclusively breast-fed healthy infants. Infants 4 months of age were eligible for the open, randomized controlled trial if their mothers intended to continue exclusive breast-feeding until the infants were 6 months of age. Infants or mothers with iron deficiency (ID) or IDA on admission were excluded. The infants (n = 79) were randomly assigned to three groups, the first group receiving daily (1 mg/kg daily), the second group weekly (7 mg/kg weekly), and the third group no iron supplementation. Anthropometric measurements were taken on admission and at 6 and 7 months of age. Iron status was analyzed on admission and monthly for 3 months. Both hematologic parameters and anthropometric measurements were found to be similar among the three groups during the study period. Seven infants (31.8%) in the control group, six (26.0%) in the daily group, and three (13.6%) in the weekly group developed ID or IDA (P > 0.05). Infants whose mothers had ID or IDA during the study period were more likely to develop ID or IDA independently from iron supplementation. Serum ferritin levels decreased between 4 and 6 months of age in the control and daily groups; the weekly group showed no such decrease. In all groups, the mean levels of serum ferritin were significantly increased from 6 months to 7 months of age during the weaning period. In this study, which had a limited number of cases, weekly or daily iron supplementation was not found to decrease the likelihood of IDA. In conclusion, exclusively breast-fed infants with maternal IDA appeared to be at increased risk of developing IDA.
Kuhn, Louise; Stein, Zena; Susser, Mervyn
Short courses of antiretroviral drugs have greatly enhanced the prospect of reducing mother-to-child HIV transmission. Yet transmission by breast feeding clouds hopes for this seemingly simple intervention. We revisit mathematical models to assess the competing risks associated with feeding by breast vs. formula. These indicate that, in the less developed world where the HIV epidemic predominates, neither option, unmodified, offers a reasonable choice for HIV-positive women. Where infant mortality rates are greater than about 40 per 1000 live births, if formula were made available to HIV-infected women only, the excess number of deaths that would result from formula use would be approximately the same or greater than the number of HIV infections that might be prevented. Only at lower infant mortality rates, less than about 40 per 1000, is the risk greater on the breast. There are thus no good grounds for the total avoidance of breast feeding under all conditions. Research to develop and test safer infant feeding alternatives is an urgent priority. On the one hand, ways to reduce HIV transmission while preserving breast feeding, as exclusive breast feeding could do, need to be fully tested. On the other hand, ways to reduce non-HIV morbidity and mortality associated with formula feeding, as educational or sanitary interventions could do, equally need testing. With either approach, a necessary foundation for implementing all the core components of preventing mother-to-child HIV transmission is competent counselling for mothers. Innovative approaches are needed to mobilise and train effective counsellors among health care workers and, as appropriate, community members.
Holman, D J; Grimes, M A
Human breast milk is primarily colostrum immediately following birth. Colostrum gradually changes to mature milk over the next several days. The role of colostrum in fighting infections and promoting growth and development of the newborn is widely acknowledged. This role is mediated by differences across cultures in the acceptability of colostrum and the prevalence of colostrum feeding. This study examined the prevalence of colostrum feeding and time to initiation of breast-feeding in 143 rural Bangladeshi women in Matlab thana. Structured interviews were collected during a 9-month prospective study conducted in 1993. Women were usually interviewed within 4 days of giving birth and were asked about whether or not they fed their child colostrum and the number of hours until they began breast-feeding the baby. Ninety per cent of the mothers reported feeding their newborn colostrum. A logistic regression found no effect on the prevalence of colostrum feeding from the following covariates: mother's age, parity, history of pregnancy loss, child's sex, mother's self-report of delivery complications, and the time from birth to interview. Fifty-nine per cent of mothers initiated breast-feeding within 4 h, and 88% within 12 h of parturition. Survival analysis was used to estimate the effects of covariates on the time from delivery to initial breast-feeding. Time to initial breast-feeding was delayed slightly, but significantly, for older mothers, for male infants, and by mothers who did not report delivery complications. The percentage of mothers who fed their child colostrum was higher, and times to initial breast-feeding were shorter, than almost all previous reports from South Asia. These findings might be explained, in part, by methodological differences among studies, but it is suggested that recent changes towards earlier initiation of breast-feeding have taken place in rural Bangladesh.
Kronborg, Hanne; Maimburg, Rikke Damkjær; Væth, Michael
to assess the effect of an antenatal training programme on knowledge, self-efficacy and problems related to breast feeding and on breast-feeding duration. a randomised controlled trial. the Aarhus Midwifery Clinic, a large clinic connected to a Danish university hospital in an urban area of Denmark. a total of 1193 nulliparous women were recruited before week 21+6 days of gestation, 603 were randomised to the intervention group, and 590 to the reference group. we compared a structured antenatal training programme attended in mid-pregnancy with usual practice. data were collected through self-reported questionnaires sent to the women's e-mail addresses and analysed according to the intention to treat principle. The primary outcomes were duration of full and any breast feeding collected 6 weeks post partum (any) and 1 year post partum (full and any). no differences were found between groups according to duration of breast feeding, self-efficacy score, or breast-feeding problems, but after participation in the course in week 36 of gestation women in the intervention group reported a higher level of confidence (p=0.05), and 6 weeks after birth they reported to have obtained sufficient knowledge about breast feeding (p=0.02). Supplemental analysis in the intervention group revealed that women with sufficient knowledge breast fed significantly longer than women without sufficient knowledge (HR=0.74 CI: 0.58-0.97). This association was not found in the reference group (HR=1.12 CI: 0.89-1.41). antenatal training can increase confidence of breast feeding in pregnancy and provide women with sufficient knowledge about breast feeding after birth. Antenatal training may therefore be an important low-technology health promotion tool that can be provided at low costs in most settings. The antenatal training programme needs to be followed by postnatal breast-feeding support as it is not sufficient in itself to increase the duration of breast feeding or reduce breast-feeding
Hawkins, Summer Sherburne; Stern, Ariel Dora; Baum, Christopher F; Gillman, Matthew W
To evaluate the impact of the Baby-Friendly Hospital Initiative (BFHI) on breast-feeding initiation and duration overall and according to maternal education. Quasi-experimental study using data from five states (Alaska, Maine, Nebraska, Ohio, Washington) that participated in the Pregnancy Risk Assessment Monitoring System from 1999 to 2009. Using differences-in-differences models that included year and hospital fixed effects, we compared rates of breast-feeding initiation and duration (any and exclusive breast-feeding for ≥4 weeks) before and after BFHI accreditation between mothers who gave birth in hospitals that were accredited or became accredited and mothers from matched non-BFHI facilities. We stratified analyses into lower and higher education groups. Thirteen BFHI hospitals and nineteen matched non-BFHI facilities across five states in the USA. Mothers (n 11 723) who gave birth in BFHI hospitals and mothers (n 13 604) from nineteen matched non-BFHI facilities. Although we did not find overall differences in breast-feeding initiation between birth facilities that received BFHI accreditation compared with non-Baby-Friendly facilities (adjusted coefficient = 0·024; 95 % CI -0·00, 0·51), breast-feeding initiation increased by 3·8 percentage points among mothers with lower education who delivered in Baby-Friendly facilities (P = 0·05), but not among mothers with higher education (adjusted coefficient = 0·002; 95 % CI -0·04, 0·05). BFHI accreditation also increased exclusive breast-feeding for ≥4 weeks by 4·5 percentage points (P = 0·02) among mothers with lower education who delivered in BFHI facilities. By increasing breast-feeding initiation and duration among mothers with lower education, the BFHI may reduce socio-economic disparities in breast-feeding.
Hawkins, Summer Sherburne; Stern, Ariel Dora; Baum, Christopher F; Gillman, Matthew W
Objective To evaluate the impact of the Baby-Friendly Hospital Initiative (BFHI) on breast-feeding initiation and duration overall and according to maternal education. Design Quasi-experimental study using data from five states (Alaska, Maine, Nebraska, Ohio, Washington) that participated in the Pregnancy Risk Assessment Monitoring System from 1999 to 2009. Using differences-in-differences models that included year and hospital fixed effects, we compared rates of breast-feeding initiation and duration (any and exclusive breast-feeding for ≥4 weeks) before and after BFHI accreditation between mothers who gave birth in hospitals that were accredited or became accredited and mothers from matched non-BFHI facilities. We stratified analyses into lower and higher education groups. Setting Thirteen BFHI hospitals and nineteen matched non-BFHI facilities across five states in the USA. Subjects Mothers (n 11723) who gave birth in BFHI hospitals and mothers (n 13604) from nineteen matched non-BFHI facilities. Results Although we did not find overall differences in breast-feeding initiation between birth facilities that received BFHI accreditation compared with non-Baby-Friendly facilities (adjusted coefficient = 0.024; 95 % CI −0.00, 0.51), breast-feeding initiation increased by 3.8 percentage points among mothers with lower education who delivered in Baby-Friendly facilities (P = 0.05), but not among mothers with higher education (adjusted coefficient = 0.002; 95 % CI −0.04, 0.05). BFHI accreditation also increased exclusive breast-feeding for ≥4 weeks by 4.5 percentage points (P=0.02) among mothers with lower education who delivered in BFHI facilities. Conclusions By increasing breast-feeding initiation and duration among mothers with lower education, the BFHI may reduce socio-economic disparities in breast-feeding. PMID:24625787
Desai, Amy; Mbuya, Mduduzi N N; Chigumira, Ancikaria; Chasekwa, Bernard; Humphrey, Jean H; Moulton, Lawrence H; Pelto, Gretel; Gerema, Grace; Stoltzfus, Rebecca J
Only 5.8% of Zimbabwean infants are exclusively breastfed for the first 6 mo of life despite substantial investment in exclusive breastfeeding (EBF) promotion throughout the country. We conducted a survey of 295 mothers of infants <6 mo of age who were recruited from rural immunization clinics and outreach sites in the Midlands Province of Zimbabwe. We explored infant feeding knowledge, beliefs and attitudes, and details regarding facilitators for EBF mothers and first foods fed by non-EBF mothers to identify and understand barriers to EBF. Among mothers of infants <1 mo, 1 to <2 mo, and 2-6 mo of age, 54%, 30%, and 12%, respectively, were practicing EBF. In adjusted multivariate analyses, EBF practice was positively associated with belief in the sufficiency of EBF (P = 0.05), belief in the avoidance of cooking oil feeding (a common traditional practice) in the first 6 mo (P = 0.001), and perceived pressure from others regarding infant feeding and traditional medicine use (P = 0.03). Psychosocial support and viewing breast milk as sufficient were reported as primary facilitators of EBF practice. Maternal responses to open-ended questions identified protection, nutrition, and crying as the main reasons for EBF interruption. During the first 2 mo of life, "protection feedings" using traditional oral remedies (such as cooking oil and water) to prevent or treat perceived illness, specifically colic and sunken/depressed fontanel, made up 78.5% of the non-breast milk feeds. From the second month of life, "nutrition feedings," mainly of water and porridge, were given when mothers believed their breast milk was insufficient in quantity or quality to meet the hunger or thirst needs of their infants. Our findings underscore the importance of exploring cultural beliefs and practices as they pertain to infant feeding and care and present insights for designing and targeting EBF promotion interventions.
Wells, Kristen J; Thompson, Nancy J; Kloeblen-Tarver, Amy S
To examine the feasibility of using the cognitive evaluation theory to examine pregnant women's intention to breast-feed. A questionnaire designed to measure intrinsic and extrinsic motivation was administered to 228 pregnant women. Results provide evidence for reliability and validity of the revised instrument in this population. A factor analysis suggests the instrument measures 2 types of intrinsic motivation, one type of extrinsic motivation, and motivation related to the baby. The instrument distinguished differences in motivation between women who intend to breast-feed and those who intend to formula feed. This study helps elucidate motivational factors involved in infant-feeding decisions.
... page: https://medlineplus.gov/news/fullstory_166793.html Breast-Feeding Tied to Lower Heart, Stroke Risk for Mom ... women who bottle-fed their babies. How might breast-feeding help heart health? One theory holds that breast- ...
Antunes, Leonardo Dos Santos; Antunes, Lívia Azeredo Alves; Corvino, Marcos Paulo Fonseca; Maia, Lucianne Cople
The importance of breast-feeding has been addressed through multi-professional approaches. As healthcare practitioners, dentists are included in this context and - due to the close links between breast-feeding and the development of the stomatognathic system - should be able to advise pregnant women and new mothers on this practice, with countless benefits for mothers and their babies. This paper thus presents up-to-date and enlightened information through a review of the literature that supports the benefits of breast-feeding, urging heightened awareness of its importance and the preparation of policies and actions implemented through Brazil's National Health System (SUS) that rank breast-feeding as a high-priority goal.
O'Tierney, Perrie F; Barker, David J P; Osmond, Clive; Kajantie, Eero; Eriksson, Johan G
Few studies have examined whether the duration of breast-feeding is associated with BMI in adult life. In the past, the heights and weights of infants and the duration of breast-feeding were routinely recorded at infant welfare clinics in Helsinki, Finland. Most infants in the city were taken to these free clinics. The Helsinki Birth Cohort comprises 13,345 people born in the city during 1934-1944; 84% were breast-fed. In 2001, a questionnaire was sent to members of the cohort asking about their weight and height. A random sample of 2003 men and women attended a clinic at which height, weight, and body composition were measured. We studied sibships that included 2 or more people from the cohort. There were 1823 subjects: 831 had completed the questionnaire; 129 had attended the clinic. We grouped the subjects according to duration of breast-feeding: 0-2 mo, 3-4 mo, 5-7 mo, and 8 mo or more. We compared siblings who were discordant for duration of breast-feeding. We found that a longer period of breast-feeding was associated with lower BMI at 1 y of age (P = 0.04 for a linear trend). This relation disappeared by the age of 7 y. People breast-fed for 5-7 mo had the lowest reported BMI at age 60 y, although this was not statistically significant; 8.8% more people breast-fed for 8 mo or more had reported BMIs that were overweight (25 to 30 kg/m(2)) compared with those breast-fed for shorter periods (P = 0.06). Breast-feeding for <2 mo or 8 mo or more was associated with an increased BMI and percentage body fat in later life, measured at the clinic (P = 0.08 and P = 0.03 for quadratic trends). We conclude that breast-feeding for <2 mo may be deleterious, possibly because of lack of exposure to protective factors in breast milk. Breast-feeding beyond 8 mo may be deleterious because mother's hormones in breast milk reset the infant's hypothalamic-pituitary-thyroid axis.
Ferrante, Antonio; Silvestri, Raffaele; Montinaro, Carlo
Publications throughout the world attribute to the artificial teat and the pacifier (dummy) the reason why some mothers, who suspend breast-feeding for a while, are unable to resume it afterwards. The authors wanted to evaluate the specific characteristics of the various commercially made teats and pacifiers. This evaluation examined the physical characteristics of such commercially available teats. It has been possible to affirm that the specific features of the various teats tested are important in the resumption of breast-feeding after such an interruption. It's easier to resume breast-feeding after interruption if artificial teats are prescribed with an understanding of the muscular movements during swallowing.
Jennifer, Fenwick; Elaine, Burns; Athena, Sheehan; Virginia, Schmied
the aim of the study was to examine the dominant discourses that midwives draw on to present information on breast feeding in group-based antenatal education sessions. breast-feeding initiation rates are high among Australian women however, duration rates are low. Antenatal breast-feeding education is considered a key strategy in promoting breast feeding to childbearing women. The efficacy and effectiveness of such a strategy is equivocal and there is little qualitative work examining group-based antenatal breast-feeding education. discourse analysis was used to explore the language and practises of midwives facilitating group antenatal breast-feeding education sessions at two Australian maternity facilities. Nine sessions were observed and tape recorded over a 12 month period. Each session lasted between 60 and 140 mins. the analysis revealed four dominate discourses midwives used to promote breast feeding during group-based antenatal education session. The predominant discourses 'There is only one feeding option': breast feeding' and 'Selling the 'breast is best' reflected how midwives used their personal and professional commitment to breast feeding, within supportive and protective policy frameworks, to convince as many pregnant women as possible to commit to breast feeding. Sessions were organised to ensure women and their partners were 'armed' with as much information as possible about the value of breastmilk, successful positioning and attachment and practical strategies to deal with early breast-feeding problems. Antenatal commitment to breast feeding was deemed necessary if women were to overcome potential hurdles and maintain a commitment to the supply of breast milk. The latter two discourses, drawn upon to promote the breast-feeding message, presented infants as 'hard wired' to breast feed and male partners as 'protectors' of breast feeding. midwives clearly demonstrated a passion and enthusiasm for breast-feeding education. Examining the dominant
Elad, David; Kozlovsky, Pavel; Blum, Omry; Laine, Andrew F.; Po, Ming Jack; Botzer, Eyal; Dollberg, Shaul; Zelicovich, Mabel; Ben Sira, Liat
How do infants extract milk during breast-feeding? We have resolved a century-long scientific controversy, whether it is sucking of the milk by subatmospheric pressure or mouthing of the nipple–areola complex to induce a peristaltic-like extraction mechanism. Breast-feeding is a dynamic process, which requires coupling between periodic motions of the infant’s jaws, undulation of the tongue, and the breast milk ejection reflex. The physical mechanisms executed by the infant have been intriguing topics. We used an objective and dynamic analysis of ultrasound (US) movie clips acquired during breast-feeding to explore the tongue dynamic characteristics. Then, we developed a new 3D biophysical model of the breast and lactiferous tubes that enables the mimicking of dynamic characteristics observed in US imaging during breast-feeding, and thereby, exploration of the biomechanical aspects of breast-feeding. We have shown, for the first time to our knowledge, that latch-on to draw the nipple–areola complex into the infant mouth, as well as milk extraction during breast-feeding, require development of time-varying subatmospheric pressures within the infant’s oral cavity. Analysis of the US movies clearly demonstrated that tongue motility during breast-feeding was fairly periodic. The anterior tongue, which is wedged between the nipple–areola complex and the lower lips, moves as a rigid body with the cycling motion of the mandible, while the posterior section of the tongue undulates in a pattern similar to a propagating peristaltic wave, which is essential for swallowing. PMID:24706845
Elad, David; Kozlovsky, Pavel; Blum, Omry; Laine, Andrew F; Po, Ming Jack; Botzer, Eyal; Dollberg, Shaul; Zelicovich, Mabel; Ben Sira, Liat
How do infants extract milk during breast-feeding? We have resolved a century-long scientific controversy, whether it is sucking of the milk by subatmospheric pressure or mouthing of the nipple-areola complex to induce a peristaltic-like extraction mechanism. Breast-feeding is a dynamic process, which requires coupling between periodic motions of the infant's jaws, undulation of the tongue, and the breast milk ejection reflex. The physical mechanisms executed by the infant have been intriguing topics. We used an objective and dynamic analysis of ultrasound (US) movie clips acquired during breast-feeding to explore the tongue dynamic characteristics. Then, we developed a new 3D biophysical model of the breast and lactiferous tubes that enables the mimicking of dynamic characteristics observed in US imaging during breast-feeding, and thereby, exploration of the biomechanical aspects of breast-feeding. We have shown, for the first time to our knowledge, that latch-on to draw the nipple-areola complex into the infant mouth, as well as milk extraction during breast-feeding, require development of time-varying subatmospheric pressures within the infant's oral cavity. Analysis of the US movies clearly demonstrated that tongue motility during breast-feeding was fairly periodic. The anterior tongue, which is wedged between the nipple-areola complex and the lower lips, moves as a rigid body with the cycling motion of the mandible, while the posterior section of the tongue undulates in a pattern similar to a propagating peristaltic wave, which is essential for swallowing.
Tarrant, Marie; Kwok, Man-Ki; Lam, Tai-Hing; Leung, Gabriel M; Schooling, C Mary
Infectious disease is a leading cause of morbidity and hospitalization for infants and children. During infancy, breast-feeding protects against infectious diseases, particularly respiratory infections, gastrointestinal infections, and otitis media. Little is known about the longer-term impact of breast-feeding on infectious disease in children. We investigated the relationship between infant feeding and childhood hospitalizations from respiratory and gastrointestinal infections in a population-based birth cohort of 8327 children born in 1997 and followed for 8 years. The main outcomes were public hospital admissions for respiratory infections, gastrointestinal infections, and all infectious diseases. Cox regression was used to assess time to first hospitalization. Breast-feeding only (no formula-feeding) for 3 or more months was associated with a lower risk of hospital admission in the first 6 months of life for respiratory infections (hazard ratio = 0.64 [95% confidence interval = 0.42-0.97]), gastrointestinal infections (0.51 [0.25-1.05]), and any infection (0.61 [0.44-0.85]), adjusted for sex, type of hospital at birth, and household income. Partial breast-feeding (both breast-feeding and formula-feeding) in the first 3 months also reduced hospitalizations from infections but with smaller effect sizes. Beyond 6 months of age, there was no association between breast-feeding status at 3 months and hospitalization for infectious disease. Giving breast milk and no formula for at least 3 months substantially reduced hospital admissions for many infectious diseases in the first 6 months of life, when children are most vulnerable.
Hahn-Holbrook, Jennifer; Holt-Lunstad, Julianne; Holbrook, Colin; Coyne, Sarah M; Lawson, E Thomas
Mothers in numerous species exhibit heightened aggression in defense of their young. This shift typically coincides with the duration of lactation in nonhuman mammals, which suggests that human mothers may display similarly accentuated aggressiveness while breast feeding. Here we report the first behavioral evidence for heightened aggression in lactating humans. Breast-feeding mothers inflicted louder and longer punitive sound bursts on unduly aggressive confederates than did formula-feeding mothers or women who had never been pregnant. Maternal aggression in other mammals is thought to be facilitated by the buffering effect of lactation on stress responses. Consistent with the animal literature, our results showed that while lactating women were aggressing, they exhibited lower systolic blood pressure than did formula-feeding or never-pregnant women while they were aggressing. Mediation analyses indicated that reduced arousal during lactation may disinhibit female aggression. Together, our results highlight the contributions of breast feeding to both protecting infants and buffering maternal stress.
Hahn-Holbrook, Jennifer; Holt-Lunstad, Julianne; Holbrook, Colin; Coyne, Sarah M.; Lawson, E. Thomas
Mothers in numerous species exhibit heightened aggression in defense of their young. This shift typically coincides with the duration of lactation in nonhuman mammals, which suggests that human mothers may display similarly accentuated aggressiveness while breast feeding. Here we report the first behavioral evidence for heightened aggression in lactating humans. Breast-feeding mothers inflicted louder and longer punitive sound bursts on unduly aggressive confederates than did formula-feeding mothers or women who had never been pregnant. Maternal aggression in other mammals is thought to be facilitated by the buffering effect of lactation on stress responses. Consistent with the animal literature, our results showed that while lactating women were aggressing, they exhibited lower systolic blood pressure than did formula-feeding or never-pregnant women while they were aggressing. Mediation analyses indicated that reduced arousal during lactation may disinhibit female aggression. Together, our results highlight the contributions of breast feeding to both protecting infants and buffering maternal stress. PMID:21873570
Tarrant, Marie; Lok, Kris Yw; Fong, Daniel Yt; Lee, Irene Ly; Sham, Alice; Lam, Christine; Wu, Kendra M; Bai, Dorothy L; Wong, Ka Lun; Wong, Emmy My; Chan, Noel Pt; Dodgson, Joan E
To investigate the effect of public hospitals in Hong Kong not accepting free infant formula from manufacturers on in-hospital formula supplementation rates and breast-feeding duration. Prospective cohort study. In-patient postnatal units of four public hospitals in Hong Kong. Two cohorts of breast-feeding mother-infant pairs (n 2560). Cohort 1 (n 1320) was recruited before implementation of the policy to stop accepting free infant formula and cohort 2 (n 1240) was recruited after policy implementation. Participants were followed prospectively for 12 months or until they stopped breast-feeding. The mean number of formula supplements given to infants in the first 24 h was 2·70 (sd 3·11) in cohort 1 and 1·17 (sd 1·94) in cohort 2 (P<0·001). The proportion of infants who were exclusively breast-fed during the hospital stay increased from 17·7 % in cohort 1 to 41·3 % in cohort 2 (P<0·001) and the risk of breast-feeding cessation was significantly lower in cohort 2 (hazard ratio=0·81; 95 % CI 0·73, 0·90). Participants who non-exclusively breast-fed during the hospital stay had a significantly higher risk of stopping any or exclusive breast-feeding. Higher levels of formula supplementation also increased the risk of breast-feeding cessation in a dose-response pattern. After implementation of a hospital policy to pay market price for infant formula, rates of in-hospital formula supplementation were reduced and the rates of in-hospital exclusive breast-feeding and breast-feeding duration increased.
Moimaz, Suzely A S; Zina, Lívia G; Saliba, Nemre A; Saliba, Orlando
In addition to providing nutrition and immunological protection, breast-feeding has positive effects on the development of the infant's oral cavity. The aim of the present study is to assess breast-feeding patterns and to analyze the influence of breast-feeding practices and maternal sociodemographic variables on the prevalence of non-nutritive sucking habits in a sample of Brazilian infants. This cross-sectional study was carried out in Southern Brazil. A random sample of 100 mothers of infants up to 12 months of age was interviewed during the National Vaccination Campaign Day. The prevalence and median duration of breast-feeding were assessed. Breast-feeding practice, the exposure factor, was categorized as exclusive breast-feeding, predominant breast-feeding, complementary breast-feeding, or weaning. Maternal sociodemographic variables included age, race, marital status, educational level, profession, and family income. The outcome investigated was the prevalence of sucking habits (pacifier use and thumb sucking). We used two-sample tests, the chi-square test and FISHER'S EXACT TEST for statistical analyses of the data. The study revealed that 75% of infants were being breast-fed. Pacifier use and thumb sucking were common in 55%. Bottle-feeding was prevalent in 74% of infants. Breast-feeding was negatively correlated with pacifier use and thumb sucking (OR=0.11; 95% CI: 0.03 to 0.4). Bottle-feeding was strongly associated with weaning (p=0.0003). Among the sociodemographic variables, only marital status showed a statistical association with sucking habits (p=0.04). These findings suggest that breast-feeding can prevent the occurrence of sucking habits. Although we could not evaluate causality assessment, malocclusion prevention seems to be yet one more reason for promoting breast-feeding practices.
Cattaneo, Adriano; Yngve, Agneta; Koletzko, Berthold; Guzman, Luis Ruiz
To describe the current situation regarding protection, promotion and support of breast-feeding in Europe, as a first step towards the development of a blueprint for action. A questionnaire was completed by 29 key informants and 128 other informants in the EU, including member states, accession and candidate countries. EU countries do not fully comply with the policies and recommendations of the Global Strategy on Infant and Young Child Feeding that they endorsed during the 55th World Health Assembly in 2002. Some countries do not even comply with the targets of the Innocenti Declaration (1990). Pre-service training on breast-feeding practice is inadequate and in-service training achieves only low to medium coverage. The Baby Friendly Hospital Initiative is well developed only in three countries; in 19 countries, less than 15% of births occur in baby-friendly hospitals. The International Code of Marketing of Breastmilk Substitutes, endorsed in 1981 by all countries, is not fully applied and submitted to independent monitoring. The legislation for working mothers meets on average the International Labour Organization standards, but covers only women with full formal employment. Voluntary mother-to-mother support groups and trained peer counsellors are present in 27 and 13 countries, respectively. Breast-feeding rates span over a wide range; comparisons are difficult due to use of non-standard methods. The rate of exclusive breast-feeding at 6 months is low everywhere, even in countries with high initiation rates. EU countries need to revise their policies and practices to meet the principles inscribed in the Global Strategy on Infant and Young Child Feeding in order to better protect, promote and support breast-feeding.
Acheson, L S; Danner, S C
Scientific studies investigating the postpartum period are scarce, and observational studies greatly outnumber controlled trials. Many studies are biased in their assumptions about the social roles of women and men and in the interpretation of observations and treatment strategies. The published literature is fragmentary; few researchers have attempted a comprehensive, biopsychosocial system-oriented view of postpartum health. More research is needed on the occurrence and treatment of such common postpartum problems as urinary incontinence, sexual dysfunction, and back pain. Widespread application of what is already known about support for breast-feeding, prevention of fatigue and depression, contraception, and maintenance of healthy lifestyles will require innovations in healthcare delivery, professional practices, and social policy, particularly in the occupational arena. Many postpartum problems have been found to be iatrogenic and responsive to changes in the routine care of mothers and newborns. Finally, it is clear that women of lower education and socioeconomic status and those with less social support are consistently at higher risk for postpartum and parenting problems; great benefits are likely from interventions that enhance the well-being of these mothers and infants.
Etanercept is a biological drug, inhibitor of the Tumor Necrosis Factor indicated for the treatment of severe or moderate psoriasis resistant to other therapies. Because its use is becoming increasingly extended, we should know its possible teratogenic effects. The data provided by the literature and studies prior to the marketing of the product are very limited. Thus, it is necessary to study the presence of possible risks more through experiments in animal models and to conduct prolonged prospective studies in humans. With the current knowledge, it seems that suspension of the treatment from one month prior to becoming pregnant would provide an adequate safety margin, and that most of the patients who have become pregnant and have suspended etanercept as soon as they knew they were pregnant have not had any complications. However, the data needed to recommend etanercept for the control of psoriasis of a pregnant woman are very limited and controversial. Since the effects of a possible transfer of etanercept to maternal milk in a still-immature immune system are not known, in accordance with the risk/benefit principle, the use of etanercept should not be recommended in breast-feeding women.
Korot'ko, G F
During the breast feeding the hydrolysis of breast milk nutrients in natural conditions provides by milk enzymes, digestive gland secrets and intestinal epitheliocyte as autolytic induced digestion with following including and development of auto-digestion in hydrolysis of milk lipids and proteins. Milk lactose is hydrolyzed as a type of auto-intestinal digestion. Breast glands release enzymes according to a year lactation dynamics. The mechanism of hydrolase recreation from the mother's blood takes part in milk hudrolase origin.
Banta-Wright, Sandra A; Shelton, Kathleen C; Lowe, Nancy D; Knafl, Kathleen A; Houck, Gail M
Breast milk is the nutrition of choice for human infants (American Academy of Pediatrics, 2005; American Association of Family Physicians, 2008; Association of Women's Health Obstetric and Neonatal Nurses, 2005; Canadian Paediatric Society, 2005; U.S. Preventive Services Task Force, 2008; World Health Organization, 2009). In comparison to standard commercial formula, human breast milk has a lower concentration of protein and a lower content of the amino acid phenylalanine (Phe). For infants with phenylketonuria (PKU), these attributes of human breast milk make it ideal as a base source of nutrition. The purpose of this study was to compare the incidence and duration of breast-feeding and corresponding Phe levels of breast-fed and formula-fed infants with PKU in the caseload of a pediatric metabolic clinic at an urban tertiary-care medical center. Charts were reviewed for infants diagnosed with PKU beginning with 2005 and ending with 1980, the year no further breast-feeding cases were identified in the PKU population. During the first year of life, most of the infants, whether breast-fed or formula-fed, had similar mean Phe levels. However, the frequency distributions revealed that more breast-fed infants with PKU had Phe levels within the normal range (120-360 μmol/L) and were less likely to have low Phe levels (<120 μmol/L) than formula-fed infants with PKU. Further research is needed to understand how mothers manage breast-feeding in the context of PKU.
Desai, Amy; Mbuya, Mduduzi N.N.; Chigumira, Ancikaria; Chasekwa, Bernard; Humphrey, Jean H.; Moulton, Lawrence H.; Pelto, Gretel; Gerema, Grace; Stoltzfus, Rebecca J.
Only 5.8% of Zimbabwean infants are exclusively breastfed for the first 6 mo of life despite substantial investment in exclusive breastfeeding (EBF) promotion throughout the country. We conducted a survey of 295 mothers of infants <6 mo of age who were recruited from rural immunization clinics and outreach sites in the Midlands Province of Zimbabwe. We explored infant feeding knowledge, beliefs and attitudes, and details regarding facilitators for EBF mothers and first foods fed by non-EBF mothers to identify and understand barriers to EBF. Among mothers of infants <1 mo, 1 to <2 mo, and 2–6 mo of age, 54%, 30%, and 12%, respectively, were practicing EBF. In adjusted multivariate analyses, EBF practice was positively associated with belief in the sufficiency of EBF (P = 0.05), belief in the avoidance of cooking oil feeding (a common traditional practice) in the first 6 mo (P = 0.001), and perceived pressure from others regarding infant feeding and traditional medicine use (P = 0.03). Psychosocial support and viewing breast milk as sufficient were reported as primary facilitators of EBF practice. Maternal responses to open-ended questions identified protection, nutrition, and crying as the main reasons for EBF interruption. During the first 2 mo of life, “protection feedings” using traditional oral remedies (such as cooking oil and water) to prevent or treat perceived illness, specifically colic and sunken/depressed fontanel, made up 78.5% of the non-breast milk feeds. From the second month of life, “nutrition feedings,” mainly of water and porridge, were given when mothers believed their breast milk was insufficient in quantity or quality to meet the hunger or thirst needs of their infants. Our findings underscore the importance of exploring cultural beliefs and practices as they pertain to infant feeding and care and present insights for designing and targeting EBF promotion interventions. PMID:24828026
Kersey, Margaret; Lipton, Rebecca; Sanchez-Rosado, Monica; Kumar, Jessica; Thisted, Ronald; Lantos, John D
Describe the relationship between breast-feeding history and risk of overweight in the preschool years in a sample of primarily Mexican-origin Latinos. Children's breast-feeding history, health history, and demographics were obtained in interviewer-administered questionnaires of a convenience sample of 364 parents of children ages 2-5 in an outpatient clinic waiting room serving a predominantly Mexican immigrant population in a large Midwestern city. Child weight status was determined by weighing and measuring each child and calculating age- and sex-specific body mass index (BMI) percentile using 2000 Centers for Disease Control reference values, with children > or =95th percentile defined as overweight. Seventy-six of 364 children (21%) were overweight. Eighty-seven percent of children had been breast-fed. Increased duration of breast-feeding was associated with a linearly decreased risk of overweight in bivariate analysis, ranging from an overweight prevalence of 35% for those never breast-fed to 12% for those breast-fed for at least a year. This inverse relationship remained significant in the smaller sample for which maternal BMI data were available (n = 127), as each additional month of breast-feeding was associated with a 10% decreased odds ratio (OR) of overweight (adjusted OR = 0.90; 95% CI = 0.81, 0.99) after controlling for child's sex, current age, prematurity, birth-weight category, maternal education level, and maternal weight status. This sample of children of Mexican-origin immigrant families had high rates of overweight at very young ages but also very high rates of breast-feeding. Duration of breast-feeding was strongly and inversely related with prevalence of overweight as a preschooler.
Rogers, Nikki L; Abdi, Jemilla; Moore, Dennis; Nd'iangui, Sarah; Smith, Linda J; Carlson, Andrew J; Carlson, Dennis
To identify specific cultural and behavioural factors that might be influenced to increase colostrum feeding in a rural village in Northern Ethiopia to improve infant health. Background interviews were conducted with six community health workers and two traditional birth attendants. A semi-structured tape-recorded interview was conducted with twenty mothers, most with children under the age of 5 years. Variables were: parental age and education; mother's ethnicity; number of live births and children's age; breast-feeding from birth through to weaning; availability and use of formula; and descriptions of colostrum v. other stages of breast milk. Participant interviews were conducted in Amharic and translated into English. Kossoye, a rural Amhara village with high prevalence rates of stunting: inappropriate neonatal feeding is thought to be a factor. Women (20-60 years of age) reporting at least one live birth (range: 1-8, mean: ∼4). Colostrum (inger) and breast milk (yetut wotet) were seen as different substances. Colostrum was said to cause abdominal problems, but discarding a portion was sufficient to mitigate this effect. Almost all (nineteen of twenty) women breast-fed and twelve (63 %) reported ritual prelacteal feeding. A majority (fifteen of nineteen, 79 %) reported discarding colostrum and breast-feeding within 24 h of birth. Prelacteal feeding emerged as an additional factor to be targeted through educational intervention. To maximize neonatal health and growth, we recommend culturally tailored education delivered by community health advocates and traditional health practitioners that promotes immediate colostrum feeding and discourages prelacteal feeding.
To explore women's experiences and perceptions of baby feeding and to explore the explanations offered by women who choose to either breast or bottle feed. A qualitative study, which was prospective in design. Participants were interviewed three times: the first stage was between six and 14 weeks of pregnancy; the second stage was between 34 and 39 weeks; and the third stage was between six and 14 weeks after childbirth. 19 participants were recruited to the study group via 12 antenatal clinics in Coventry, UK. The data indicate that participants make baby-feeding decisions either prior to conception or early in the pregnancy. Findings also indicate that both breast and bottle feeders possessed knowledge of the benefits of breast feeding, but this did not seem to influence decision making. One of the most significant factors influencing the decision to bottle feed appears to be a desire for paternal involvement. To increase the incidence of breast feeding, health-care professionals should consider the need for preconceptual health promotion. The role of paternal involvement in baby-feeding decisions also needs to be acknowledged and men need to be included in breast-feeding promotion campaigns.
Hawkins, Summer Sherburne; Stern, Ariel Dora; Gillman, Matthew W
Despite the passage of state laws promoting breast feeding, a formal evaluation has not yet been conducted to test whether and/or what type of laws may increase breast feeding. The enactment of breastfeeding laws in different states in the USA creates a natural experiment. We examined the impact of state breastfeeding laws on breastfeeding initiation and duration as well as on disparities in these infant feeding practices. Using data from the Pregnancy Risk Assessment Monitoring System, we conducted differences-in-differences models to examine breastfeeding status before and after the institution of laws between 2000 and 2008 among 326 263 mothers from 32 states in the USA. For each mother, we coded the presence of two types of state breastfeeding laws. Mothers reported whether they ever breast fed or pumped breast milk (breastfeeding initiation) and, if so, how long they continued. We defined breastfeeding duration as continuing to breast feed for ≥4 weeks. Breastfeeding initiation was 1.7 percentage points higher in states with new laws to provide break time and private space for breastfeeding employees (p=0.01), particularly among Hispanic mothers (adjusted coefficient 0.058). While there was no overall effect of laws permitting mothers to breast feed in any location, among Black mothers we observed increases in breastfeeding initiation (adjusted coefficient 0.056). Effects on breastfeeding duration were in the same direction, but slightly weaker. State laws that support breast feeding appear to increase breastfeeding rates. Most of these gains were observed among Hispanic and Black women and women of lower educational attainment suggesting that such state laws may help reduce disparities in breast feeding.
Lipworth, L; Bailey, L R; Trichopoulos, D
The purpose of this review is to critically evaluate the collective epidemiologic evidence that a history of breast-feeding may decrease the risk of breast cancer. Original data for inclusion were identified through a MEDLINE(R) search of the English language literature from 1966 through 1998. To date, virtually all epidemiologic data regarding breast-feeding and breast cancer risk are derived from case-control studies, which vary according to classification of breast-feeding history. Overall, the evidence with respect to "ever" breast-feeding remains inconclusive, with results indicating either no association or a rather weak protective effect against breast cancer. An inverse association between increasing cumulative duration of breast-feeding and breast cancer risk among parous women has been reported in some, but not all, studies; the failure to detect an association in some Western populations may be due to the low prevalence of prolonged breast-feeding. It appears that the protective effect, if any, of long-term breast-feeding is stronger among, or confined to, premenopausal women. It has been hypothesized that an apparently protective effect of breast-feeding may be due to elevated breast cancer risk among women who discontinue breast-feeding or who take medication to suppress lactation; however, the evidence is limited and should be interpreted with caution. The biology underlying a protective effect of breast-feeding and why this should be restricted to premenopausal women remain unknown, although several mechanisms have been postulated (hormonal changes, such as reduced estrogen; removal of estrogens through breast fluid; excretion of carcinogens from breast tissue through breast-feeding; physical changes in the mammary epithelial cells, reflecting maximal differentiation; and delay of the re-establishment of ovulation). While breast-feeding is a potentially modifiable behavior, the practical implication of reduced breast cancer risk among premenopausal
Zadrozny, Sabrina; Westreich, Daniel; Hudgens, Michael G; Chasela, Charles; Jamieson, Denise J; Martinson, Francis; Zimba, Chifundo; Tegha, Gerald; Hoffman, Irving; Miller, William C; Pence, Brian W; King, Caroline C; Kourtis, Athena P; Msungama, Wezi; van der Horst, Charles
The relationship between mastitis and antiretroviral therapy among HIV-positive, breast-feeding women is unclear. In the Breastfeeding, Antiretrovirals, and Nutrition (BAN) study, conducted in Lilongwe, Malawi, 2369 mother-infant pairs were randomized to a nutritional supplement group and to one of three treatment groups: maternal antiretroviral therapy (ART), infant nevirapine (NVP) or standard of care for 24 weeks of exclusive breast-feeding and 4 weeks of weaning. Among 1472 HIV-infected women who delivered live infants between 2004 and 2007, we estimated cumulative incidence functions and sub-distribution hazard ratios (HR) of mastitis or breast inflammation comparing women in maternal ART (n = 487) or infant nevirapine (n = 492) groups to the standard of care (n = 493). Nutritional supplement groups (743 took, 729 did not) were also compared. Through 28-weeks post-partum, 102 of 1472 women experienced at least one occurrence of mastitis or breast inflammation. The 28-week risk was higher for maternal ART (risk difference (RD) 4.5, 95% confidence interval (CI) 0.9, 8.1) and infant NVP (RD 3.6, 95% CI 0.3, 6.9) compared to standard of care. The hazard of late-appearing mastitis or breast inflammation (from week 5-28) was also higher for maternal ART (HR 6.7, 95% CI 2.0, 22.6) and infant NVP (HR 5.1, 95% CI 1.5, 17. 5) compared to the standard of care. Mastitis or breast inflammation while breast-feeding is a possible side effect for women taking prophylactic ART and women whose infants take NVP, warranting additional research in the context of postnatal HIV transmission. © 2017 John Wiley & Sons Ltd.
Martin-Bautista, Elena; Gage, Heather; von Rosen-von Hoewel, Julia; Jakobik, Viktoria; Laitinen, Kirsi; Schmid, Martina; Morgan, Jane; Williams, Peter; Decsi, Tamas; Campoy, Cristina; Koletzko, Berthold; Raats, Monique
To (i) identify and describe prevailing infant feeding policy documents in five diverse European countries; (ii) analyse types of health outcomes for the infant that are associated with feeding breast milk rather than formula milk in the documents of different countries; and (iii) assess the extent to which documents reflect the WHO global recommendation of exclusive breast-feeding for 6 months. Documentary review and analysis. Five geographically dispersed countries of Europe (England, Finland, Germany, Hungary and Spain). Policy documents on infant feeding were identified; statements that linked choice between breast- and formula-feeding to a health outcome for the infant were extracted. Twenty-six documents (varied authorships, dates, length and character) were identified: four from England; two from Finland; nine from Germany; six from Hungary; and five from Spain. There was no consistency in the way in which health outcomes were cited as factors in the recommendations for breast- rather than formula-feeding. Seven documents contained no reference to the health implications of infant feeding choice. Of 203 statements in remaining documents citing health outcomes, 24.1 % mentioned general health effects, 32.5 % protection against infections, 31.5 % long-term conditions (e.g. diabetes, CVD) and 11.8 % mentioned allergy. Health outcomes were linked to exclusive breast-feeding in only 25 % of statements. Policy documents in the study countries varied in the extent to which they reflect the health outcomes for the baby of breast-feeding, and this may limit effective promotion by health professionals. There is scope to improve the process of bringing evidence and recommendations into policy documents.
Raisler, J; Alexander, C; O'Campo, P
The purpose of this study was to determine whether breast-feeding has a dose-related protective effect against illness and whether it confers special health benefits to poor infants. The association between breast-feeding dose and illnesses in the first 6 months of life was analyzed with generalized estimating equations regression for 7092 infants from the National Maternal and Infant Health Survey. Breast-feeding dose (ratio of breast-feedings to other feedings) was categorized as full, most, equal, less, or no breast-feeding. Compared with no breast-feeding, full breast-feeding infants had lower odds ratios of diarrhea, cough or wheeze, and vomiting and lower mean ratios of illness months and sick baby medical visits. Most breast-feeding infants had lower odds ratios of diarrhea and cough or wheeze, and equal breast-feeding infants had lower odds ratios of cough or wheeze. Full, most, and equal breast-feeding infants without siblings had lower odds ratios of ear infections and certain other illnesses, but those with siblings did not. Less breast-feeding infants had no reduced odds ratios of illness. Findings did not vary by income. Full breast-feeding was associated with the lowest illness rates. Minimal (less) breast-feeding was not protective. Breast-feeding conferred similar health benefits in all economic groups.
Raisler, J; Alexander, C; O'Campo, P
OBJECTIVES: The purpose of this study was to determine whether breast-feeding has a dose-related protective effect against illness and whether it confers special health benefits to poor infants. METHODS: The association between breast-feeding dose and illnesses in the first 6 months of life was analyzed with generalized estimating equations regression for 7092 infants from the National Maternal and Infant Health Survey. Breast-feeding dose (ratio of breast-feedings to other feedings) was categorized as full, most, equal, less, or no breast-feeding. RESULTS: Compared with no breast-feeding, full breast-feeding infants had lower odds ratios of diarrhea, cough or wheeze, and vomiting and lower mean ratios of illness months and sick baby medical visits. Most breast-feeding infants had lower odds ratios of diarrhea and cough or wheeze, and equal breast-feeding infants had lower odds ratios of cough or wheeze. Full, most, and equal breast-feeding infants without siblings had lower odds ratios of ear infections and certain other illnesses, but those with siblings did not. Less breast-feeding infants had no reduced odds ratios of illness. Findings did not vary by income. CONCLUSIONS: Full breast-feeding was associated with the lowest illness rates. Minimal (less) breast-feeding was not protective. Breast-feeding conferred similar health benefits in all economic groups. PMID:9987460
Previous studies suggest that access to modern contraceptives can reduce breast-feeding rates because women who had been using breast-feeding to avoid pregnancy substitute away from it. This article shows that contraceptive use can also have a positive effect on breast-feeding. A mother often weans a child if she becomes pregnant again, which can occur sooner than desired if she lacks access to contraceptives. Thus, by enabling longer birth spacing and preventing unwanted pregnancies, contraceptive use allows for a longer duration of breast-feeding. This positive effect should primarily affect infants who are past the first few months of life because their mothers are more fecund then, and the negative effect should affect infants who are very young because the contraceptive property of breast-feeding is strongest then. I test for these dual effects using Demographic and Health Survey data for Indonesia. I find evidence of the positive birth-spacing effect: contraceptive use increases the likelihood that children continue to be breast-fed past age 1. There is also suggestive evidence of a negative substitution effect among infants age 3 months and younger.
Dalal, Priti G; Bosak, Jodi; Berlin, Cheston
There has been an increase in breast-feeding supported by the recommendations of the American Academy of Pediatrics and the World Health Organization. An anesthesiologist may be presented with a well-motivated breast-feeding mother who wishes to breast-feed her infant in the perioperative period. Administration of anesthesia entails acute administration of drugs with potential for sedation and respiratory effects on the nursing infant. The short-term use of these drugs minimizes the possibility of these effects. The aim should be to minimize the use of narcotics and benzodiazepines, use shorter acting agents, use regional anesthesia where possible and avoid agents with active metabolites. Frequent clinical assessments of the nursing infant are important. Available literature does suggest that although the currently available anesthetic and analgesic drugs are transferred in the breast milk, the amounts transferred are almost always clinically insignificant and pose little or no risk to the nursing infant. © 2013 John Wiley & Sons Ltd.
Bahadori, Babak; Riediger, Natalie D; Farrell, Sharla M; Uitz, Elisabeth; Moghadasian, Mohammed F
A number of studies, including new data summarized here, conclude that breast feeding duration is lower in smoking mothers. Although some have suggested that this merely reflects poor health motivation in those prone to smoke, several lines of evidence support the view that chronic smoking does indeed compromise breast feeding by suppressing prolactin secretion and thereby lowering breast milk volume. Moreover, a recent clinical trial shows that an effective smoking cessation program can boost breast feeding duration in smokers. An analysis of pertinent rodents studies suggests that chronic nicotine administration boosts dopaminergic activity in the tuberoinfundibular tract which functions to inhibit prolactin release; this increase in dopaminergic activity, in turn, may reflect a nicotine-mediated suppression of hypothalamic opioid activity.
Carreira, Helena; Bastos, Ana; Peleteiro, Bárbara; Lunet, Nuno
To quantify the association between breast-feeding and Helicobacter pylori infection, among children and adolescents. We searched MEDLINE™ and Scopus™ up to January 2013. Summary relative risk estimates (RR) and 95 % confidence intervals were computed through the DerSimonian and Laird method. Heterogeneity was quantified using the I² statistic. Twenty-seven countries/regions; four low-income, thirteen middle-income and ten high-income countries/regions. Studies involving samples of children and adolescents, aged 0 to 19 years. We identified thirty-eight eligible studies, which is nearly twice the number included in a previous meta-analysis on this topic. Fifteen studies compared ever v. never breast-fed subjects; the summary RR was 0·87 (95% CI 0·57, 1·32; I²=34·4%) in middle-income and 0·85 (95% CI 0·54, 1·34; I²=79·1%) in high-income settings. The effect of breast-feeding for ≥4-6 months was assessed in ten studies from middle-income (summary RR=0·66; 95% CI 0·44, 0·98; I²=65·7%) and two from high-income countries (summary RR=1·56; 95% CI 0·57, 4·26; I²=68·3%). Two studies assessed the effect of exclusive breast-feeding until 6 months (OR=0·91; 95% CI 0·61, 1·34 and OR=1·71; 95% CI 0·66, 4·47, respectively). Our results suggest a protective effect of breast-feeding in economically less developed settings. However, further research is needed, with a finer assessment of the exposure to breast-feeding and careful control for confounding, before definite conclusions can be reached.
Sépou, A; Yanza, M C; Nguémbi, E; Tekpa, G; Ngbalè, R
Efforts have been made for several years to promote the use of breast milk by mothers. This is important for mothers in developing countries faced with economic problems, especially for those tempted by milk substitutes. Fortunately, BF (breast feeding) is used by a majority of women in these developing countries, its practice is often influenced by an early introduction of supplements. Why this early supplementation? In order to answer this question we performed this study, a transversal survey of mothers in neonatal period in a regional town and the capital of Central Africa. The compilation of data of this seven month study, carried out in four maternities and nine SMI centers, was carried out from a pre-established questionnaire. This allowed us to obtain the following results. We interrogated 734 mothers of newborn babies aged between 14 and 45 years, including 534 in Bangui and 200 in Bossangoa. Breast feeding was chosen by 96.5% of mothers, however exclusive breast feeding was only carried out by 17% of mothers. Feeding on demand was widely spread both in Bangui (92.7%) and in Bossangoa (92%). Breast milk was the first food received at birth by 84.5% of newborn babies. At the neonatal period, water supplementation was more frequent (78.1%, including 23% at birth) than that of solid or semi-liquid food (6.2%). The value given to breast milk was just nutritional, its other virtues were not well known. Conclusion, In breast mil remains the food of choice in our country. However, its practice suffers from much ignorance. An effort should be made to heighten awareness and give milk its due worth.
Gdalevich, M; Mimouni, D; Mimouni, M
The protective effect of breast-feeding on the development of childhood asthma remains a matter of controversy. We conducted a systematic review of prospective studies that evaluated the association between exclusive breast-feeding during the first 3 months after birth and asthma. We searched the 1966-1999 MEDLINE database and reviewed reference lists of relevant articles to identify 12 prospective studies that met pre-stated inclusion criteria. Methodological aspects of the studies, duration and exclusivity of breast-feeding, and outcomes were assessed. Effect estimates were abstracted by the investigators, using a standardized approach. The summary odds ratio (OR) for the protective effect of breast-feeding was 0.70 (95% CI 0.60 to 0.81). The effect estimate was greater in studies of children with a family history of atopy (OR = 0.52) than in studies of a combined population (OR = 0.73). Exclusive breast-feeding during the first months after birth is associated with lower asthma rates during childhood. The effect, caused by immunomodulatory qualities of breast milk, avoidance of allergens, or a combination of these and other factors, strengthens the advantage of breast-feeding, especially if a family history of atopy is present.
Taki, M; Mizuno, K; Murase, M; Nishida, Y; Itabashi, K; Mukai, Y
To obtain a better understanding of the changes in feeding behaviour from 1 to 6 months of age. By comparing breast- and bottle-feeding, we intended to clarify the difference in longitudinal sucking performance. Sucking variables were consecutively measured for 16 breast-fed and eight bottle-fed infants at 1, 3 and 6 months of age. For breast-feeding, number of sucks per burst (17.8 +/- 8.8, 23.8 +/- 8.3 and 32.4 +/- 15.3 times), sucking burst duration (11.2 +/- 6.1, 14.7 +/- 8.0 and 17.9 +/- 8.8 sec) and number of sucking bursts per feed (33.9 +/- 13.9, 28.0 +/- 18.2 and 18.6 +/- 12.8 times) at 1, 3 and 6 months of age respectively showed significant differences between 1 and 6 months of age (p < 0.05). The sucking pressure and total number of sucks per feed did not differ among different ages. Bottle-feeding resulted in longer sucking bursts and more sucks per burst compared with breast-feeding in each month (p < 0.05). The increase in the amount of ingested milk with maturation resulted from an increase in bolus volume per minute as well as the higher number of sucks continuously for both breast- and bottle-fed infants.
Vestermark, V; Høgdall, C K; Plenov, G; Birch, M
The duration of postpartum amenorrhoea was studied in a Danish sample of 361 women. The median duration of amenorrhoea was 17 weeks. The 25th and 75th percentiles were 10 and 30 weeks, respectively. A significant correlation was found between the duration of postpartum amenorrhoea and of breast-feeding. However, lactation for more than 9 months did not extend the duration of amenorrhoea. Menstruation before weaning occurred in 57% of the women, and 43% terminated breast-feeding before the first menstruation. Four weeks after weaning menstruation had returned in 79% and by 8 weeks after in 93% of the mothers. At 6 months postpartum, frequency of breast-feeding, and of night-time feeding were determinants of amenorrhoea.
International AIDS experts and HIV infected women in Africa may soon face an impossible dilemma if short-term AZT treatment prevents perinatal transmission. HIV-infected mothers may not be able to afford infant formula or may not have access to safe water to mix with the formula, and may expose the child to HIV again through breast feeding. Few studies have addressed the breast feeding issue, although a controversial placebo-controlled study is underway in Nairobi. Pediatricians have promoted breast feeding as the preferred means to feed infants, and in many cases, mothers do not have other viable choices. Women who cannot afford formula may be forced to expose their children to HIV.
Breast-feeding is the feeding method of choice for all normal infants because of its many advantages for the health of infants and mothers alike. There are, however, a number of situations—fortunately relatively infrequent—where infants cannot, or should not, be breast-fed. Such circumstances can be related to the health of infants or mothers; in either case, breast-milk substitutes may be needed for extended periods. In this context, it is useful to distinguish between infants who should not receive breast milk at all and infants who cannot be fed at the breast, but for whom breast milk is still the food of choice. There is also a tiny minority of infants who should not be fed either on breast milk or any milk-based substitute; special preparations are required in such cases. Finally, there are also a number of situations which are frequently thought to be an impediment to breast-feeding but which in fact generally are not; these, too, are discussed. PMID:20604469
Deang, L P; Doan, R M; Popkin, B M
Researchers applied longitudinal data on 2884 women who were at least 6 months pregnant between May 1983-April 1984 and living in the Cebu metropolitan area, the Philippines to examine assumptions which may explain the association between lower breast feeding levels and dwindling social support for mothers who breast feed in urban areas. Extended family households were much more common in urban areas than rural areas (46.3% vs. 27.5%). This finding did not support the 3rd assumption of falling extended family patterns with urbanization. Further as the levels of complexity and extension of the household rose so did infant care support regardless of location. For example, the number of hours of help with infant care for mothers in nuclear families in urban areas was 1.23 which climbed from 2.53 for horizontal extended families to 2.9 for vertical extended families and to 3.09 for horizontal and vertical extended families. This result supported the 2nd assumption of much more social support in extended families than nuclear families. Yet social support did not translate into promotion of breast feeding--the 1st assumption. Mothers in horizontally extended families had a lower likelihood of breast feeding than those in nuclear families. Further only adult female relatives of the same generation as the mother has a negative influence on breast feeding in urban mothers, but not rural mothers. In fact, female children of at least 7 years old, female servants, and yayas all negatively affect breast feeding in urban mothers, but not rural mothers. In rural households, young female relatives (at least 7 years old) significantly increased the probability of breast feeding whereas young male relatives decreased the probability.
Owen, Christopher G; Whincup, Peter H; Cook, Derek G
This paper considers the body of observational evidence examining the association of being breast-fed to cardiovascular risk factors and outcomes in later life, and whether any potentially advantageous findings are causal. Early cardiovascular consequences/correlates of breast-feeding, compared to being formula fed, include markedly higher levels of total blood cholesterol, lower levels of pre-prandial blood glucose and insulin and lower levels of adiposity. However, a key issue is whether these early differences at a period of rapid development programme/influence cardiovascular risk factors and outcomes in later life. Evidence of long-term effects of early feeding, largely from observational studies, has shown that those breast-fed have lower levels of blood total cholesterol, lower risk of type-2 diabetes and marginally lower levels of adiposity and blood pressure in adult life. There is no strong evidence to suggest effects of early feeding on adult levels of blood glucose, blood insulin and CHD outcomes, although further data are needed. However, the influence of confounding factors, such as maternal body size, maternal smoking and socio-demographic factors, and exclusivity of early feeding on these potentially beneficial associations needs to be considered before inferring any causal effects. Moreover, fewer studies have examined whether duration of exclusive breast-feeding has a graded influence on these risk factors and outcomes; such data would help further in deciding upon causal associations. While strong observational evidence suggests nutritional programming of adult cholesterol levels, associations with other markers of cardiometabolic risk and their consequences in later life need to be confirmed in well-conducted observational and experimental studies.
van den Hooven, Edith H; Gharsalli, Mounira; Heppe, Denise H M; Raat, Hein; Hofman, Albert; Franco, Oscar H; Rivadeneira, Fernando; Jaddoe, Vincent W V
Breast-feeding has been associated with later bone health, but results from previous studies are inconsistent. We examined the associations of breast-feeding patterns and timing of introduction of solids with bone mass at the age of 6 years in a prospective cohort study among 4919 children. We collected information about duration and exclusiveness of breast-feeding and timing of introduction of any solids with postnatal questionnaires. A total body dual-energy X-ray absorptiometry scan was performed at 6 years of age, and bone mineral density (BMD), bone mineral content (BMC), area-adjusted BMC (aBMC) and bone area (BA) were analysed. Compared with children who were ever breast-fed, those never breast-fed had lower BMD (-4·62 mg/cm2; 95 % CI -8·28, -0·97), BMC (-8·08 g; 95 % CI -12·45, -3·71) and BA (-7·03 cm2; 95 % CI -12·55, -1·52) at 6 years of age. Among all breast-fed children, those who were breast-fed non-exclusively in the first 4 months had higher BMD (2·91 mg/cm2; 95 % CI 0·41, 5·41) and aBMC (3·97 g; 95 % CI 1·30, 6·64) and lower BA (-4·45 cm2; 95 % CI -8·28, -0·61) compared with children breast-fed exclusively for at least 4 months. Compared with introduction of solids between 4 and 5 months, introduction <4 months was associated with higher BMD and aBMC, whereas introduction between 5 and 6 months was associated with lower aBMC and higher BA. Additional adjustment for infant vitamin D supplementation did not change the results. In conclusion, results from the present study suggest that ever breast-feeding compared with never breast-feeding is associated with higher bone mass in 6-year-old children, but exclusive breast-feeding for 4 months or longer was not positively associated with bone outcomes.
Zhu, Jiemin; Chan, Wai Chi Sally; Zhou, Xiuzhu; Ye, Benlan; He, Hong-Gu
to examine breast feeding self-efficacy and identify its predictors among expectant Chinese mothers in the antenatal period. a cross-sectional descriptive questionnaire survey was conducted in the antenatal clinics of three university hospitals in China between September and December 2011. expectant mothers planning to breast feed, and who were at least 18 years of age, expecting a single, healthy, full-term baby, and competent in Mandarin (n=201). a socio-demographic data sheet, the Chinese version of the Breastfeeding Self-Efficacy Scale, and the Perceived Social Support Scale. the expectant Chinese mothers reported moderate levels of breast feeding self-efficacy. Expectant mothers who had had previous experience in breast feeding, who had watched other mothers breast feed their infants, or who had made the decision to breast feed earlier reported higher breast feeding self-efficacy. Expectant mothers' perceived social support, perceived attitude of significant others, including husband, mothers, and friends, towards breast feeding are correlated with breast feeding self-efficacy. The best-fit regression analysis revealed five variables that explained 34% of the variance in breast feeding self-efficacy in the antenatal period: perceived social support, previous experience of breast feeding, previous experience of watching others breast feed, timing of maternal decision to breast feed, and perceived husband's attitude towards breast feeding. this study highlighted the importance of improving Chinese mothers' breast feeding self-efficacy by considering the main predictors found in this study. health care professionals could develop strategies to promote breast feeding self-efficacy, such as providing opportunities for expectant mothers to learn from others' successful experience, adopt a family-centred approach in the provision of breast feeding education, provide breast feeding education at the beginning of pregnancy or even earlier, and rally comprehensive social
Couper, J J; Steele, C; Beresford, S; Powell, T; McCaul, K; Pollard, A; Gellert, S; Tait, B; Harrison, L C; Colman, P G
The hypothesis that early exposure to cow's milk or lack of breast-feeding predisposes to type 1 diabetes remains controversial. We aimed to determine prospectively the relationship of, first, duration of exclusive breast-feeding and total duration of breast-feeding, and second, introduction of cow's milk protein as infant formula, cow's milk, or dairy products, to the development of islet antibodies in early life. Some 317 children with a first-degree relative with type 1 diabetes were followed prospectively from birth for 29 months (4-73). Mothers kept a home diary and answered infant feeding questionnaires at 6-month intervals. No systematic feeding advice was given. Insulin autoantibodies (normal range <5.5%), anti-GAD antibodies (<5.0 U), and anti-IA2 antibodies (<3.0 U) were measured at 6-month intervals. Cox proportional hazards model of survival analysis detected no significant difference between children who did not develop islet antibodies (225 of 317 [71%]), children with one islet antibody raised once (52 of 317 [16.4%]), children with one antibody raised repeatedly (18 of 317 [5.7%]), or children with two or more antibodies raised (22 of 317 [6.9%]), in terms of duration of exclusive breast-feeding, total duration of breast-feeding, or introduction of cow's milk-based infant formulas, cow's milk, or dairy products (relative risk: 0.91-1.09). Four of the children with two or more islet antibodies developed type 1 diabetes. We conclude that there is no prospective association between duration of breast-feeding or introduction of cow's milk and the development of islet autoimmunity in high-risk children.
Chulada, Patricia C; Arbes, Samuel J; Dunson, David; Zeldin, Darryl C
Asthma prevalence has increased dramatically in recent years, especially among children. Breast-feeding might protect children against asthma and related conditions (recurrent wheeze), and this protective effect might depend on the duration and exclusivity of the breast-feeding regimen. We sought to determine whether there is an association between breast-feeding and asthma, recurrent wheeze, or both in children up to 72 months of age and whether the duration and exclusivity of breast-feeding affect this association. Data were from the third National Health and Nutrition Examination Survey, a nationally representative cross-sectional survey conducted from 1988 to 1994. We tested for significant associations between breast-feeding and physician-diagnosed asthma and recurrent wheeze (> or =3 episodes in the past 12 months) before and after adjusting for potential confounders. Crude analyses showed that breast-feeding was associated with significantly reduced risks for asthma and recurrent wheeze in children 2 to 71 months of age, but after adjusting for potential confounders, these overall protective associations attenuated and were no longer statistically significant. However, 2 new and important associations were revealed after adjusting for confounders: (1) compared with never breast-fed children, ever breast-fed children had significantly reduced odds of being diagnosed with asthma and of having recurrent wheeze before 24 months of age, and (2) among children 2 to 71 months of age who had been exposed to environmental tobacco smoke, those who had ever been breast-fed had significantly reduced risks of asthma and wheeze compared with those who had never been breast-fed. Breast-feeding might delay the onset of or actively protect children less than 24 months of age against asthma and recurrent wheeze. Breast-feeding might reduce the prevalence of asthma and recurrent wheeze in children exposed to environmental tobacco smoke.
Mother's milk protects the newborn against various infections, especially against gastrointestinal infections, as well as strengthening the mother-child bond. Breast-feeding is also associated with birth spacing and plays an important role in the regulation of fertility in countries where the rate of use of contraceptives is low. In breast-feeding women amenorrhea may last several months or even a year, while in women who do not breast-feed menstruation returns 35-40 days postpartum. The risk of getting pregnant in women who rely on amenorrhea for contraception increases with the appearance of the first postpartum menstruation (spotting), with the introduction of food supplement into the diet of the infant, and approximately 6 months after childbirth. Family planning programs have to collaborate with maternal health programs with respect to the need for contraception, including postpartum contraception, which involves the training of nurse-midwives or traditional birth attendants. The choice of contraceptives includes the IUD, with a high degree of efficacy, which is particularly advantageous during breast-feeding. Tubal ligation has no negative effect on breast-feeding, but it also requires proper counseling. Other methods are vasectomy, implants and injectables containing progestational hormones, and estrogen-progesterone containing pills, which should not be used for 6 weeks after childbirth.
Grunewald, Maria; Hellmuth, Christian; Demmelmair, Hans; Koletzko, Berthold
Breast-feeding is considered to offer optimal nutrition for healthy infant growth and development. Observational studies have linked breast-feeding to reduced obesity. CASE OBSERVATION: We observed an infant who was born macrosomic (4.56 kg) and showed excessive weight gain markedly exceeding the 97th percentile of weight during full breast-feeding. At the age of 4 months, the weight was greater than 11 kg. Clinical evaluation did not reveal any underlying pathology. After the introduction of complementary feeding and hence reduction of the breast milk intake, the excessive weight gain was attenuated and the slope of the percentile curve paralleled upper percentiles. Since this pattern suggested full breast-feeding as the driver of excessive weight gain, we analyzed the human milk composition at the infant age of 1 year and compared the results with published data on composition at this stage of lactation. The milk contents of lactose, fat, fatty acids, polar lipids, carnitine species, and insulin were similar to the reference data. The adiponectin content was increased. The most remarkable alteration was a high milk protein content (mean 1.25 g/dl, reference 0.8 g/dl). A very high protein supply in infancy has been previously shown to increase plasma concentrations of the growth factors insulin and IGF-1, weight gain, and later obesity. We speculate that interindividual variations in human milk adiponectin and protein contents may contribute to modulation of the growth of fully breast-fed infants and in this case may have contributed to excessive weight gain during full breast-feeding. This hypothesis merits being tested in future cohort studies. © 2014 S. Karger AG, Basel.
Donaldson, Mark; Goodchild, Jason H
Despite advances in the study of birth defects related to drug exposures during pregnancy, medication use during pregnancy still causes anxiety and misunderstanding among both members of the public and health care professionals. This may result in a woman's unknowingly taking a medication that may harm the fetus or cause a birth defect or discontinuing medications necessary for treating chronic conditions. Using medications while breast-feeding also represents a challenge for patients and prescribers. Many mothers are told they must stop breast-feeding or "pump and discard" their breast milk if they are taking certain medications; however, in many cases, this advice-based on what may be limited education on the part of the health care provider about breast-feeding and medication use-may be incorrect. The authors review the current evidence regarding drugs that may be safe for pregnant or breast-feeding patients and medications that such patients should avoid. When considering prescribing in pregnancy, the dentist must weigh the risk to the fetus versus the benefit to the mother, and the appropriate conclusion should reflect current evidence. In some cases medication dosing should be avoided or altered; however, there are times when it is unnecessary to stop the use of medications. Breast-feeding also represents a clinical challenge, the risks and benefits of which need to be understood by both the patient and practitioner before any medication is administered. Dentists should be familiar with the risks and benefits for pregnant or breast-feeding patients posed by five types of medications: analgesics and anti-inflammatories, antibiotics, local anesthetics, sedatives and emergency medications.
Makay, Balahan; Unsal, Erbil
Familial Mediterranean fever (FMF) is the most common inherited autoinflammatory disease, which is caused by an inborn error in innate immune system. It was shown that disease severity of patients of the same ethnic origin differed according to different country of residence, suggesting an influence of environment on phenotype of FMF. Different microbial milieus of the countries were accused. Breast-feeding has an important role on innate immunity and protects the infant from infections. The aim of this study is to investigate whether being breast-fed and duration of breast-feeding has an impact on disease severity of FMF. The mothers of patients were asked to fill a questionnaire about the feeding type in infancy. Mode of delivery, gestational age, and age at onset of FMF symptoms were also asked. The disease severity score of each patient was calculated according to the scoring system suggested by Pras et al. (Am J Med Genet 75:216-219, 1998). MEFV mutations were noted. The mothers of 81 FMF patients completed the questionnaire. Fifteen patients (18.5%) had mild, 49 (60.5%) had moderate, and 17 (21%) had severe disease. All the patients except four were breast-fed for some period. The duration of breast-feeding was similar between three severity groups. Time to introduce cow's milk and complementary foods also did not differ between groups. Longer duration of breast-feeding did not delay the onset of FMF symptoms. Mode of delivery and gestational age had no effect on disease severity. Patients homozygous for M694V had higher severity scores. This preliminary study suggests that breast-feeding is not an exogenous factor having an influence on phenotype of FMF. M694V genotype seems to cause more severe disease.
Alus Tokat, Merlinda; Serçekuş, Pinar; Yenal, Kerziban; Okumuş, Hülya
To compare the breast-feeding outcomes and breast-feeding self-efficacy, in the first 24 postpartum hours, of mothers who underwent vaginal birth, cesarean birth with epidural anesthesia, and cesarean birth with general anesthesia. A comparative study was conducted in Turkey. A total of 334 mothers participated. Data were evaluated through descriptive data form, breast-feeding outcomes form, and the Breastfeeding Self-Efficacy Scale. It was observed that the mothers who had cesarean birth with general anesthesia experienced more breast-feeding problems. With regard to breast-feeding self-efficacy, all the groups were similar. For reducing breast-feeding problems, nurses should provide more care and support to mothers undergoing cesarean birth. Therefore, the fact that the breast-feeding self-efficacy was similar among the groups might be related to culture. © 2014 NANDA International, Inc.
Leite-Cavalcanti, Alessandro; Medeiros-Bezerra, Priscila K; Moura, Cristiano
This study was aimed at verifying the prevalence of nutritive (breast-feeding and bottle-feeding) and non-nutritive sucking habits and the presence of malocclusion in Brazilian preschool children. The study was a cross-sectional oral health survey of 342 children (196 boys and 146 girls) between the ages of 3 and 5 in Campina Grande, Brazil. The data was collected by interviews with the children's mothers or minders and by clinical examinations carried out by a calibrated examiner (kappa = 0,86). Descriptive statistics using the EPI-INFO Program (version 3.3) and Chi-square test at 0.05 probability level were produced. Sucking habit prevalence was very high in all groups, ranging from 70 % to 77,4 %. Malocclusion was present in 87 %, dummy use in 84,8 % and finger-sucking in 7,2 %. About 84,2 % of the children had a history of bottle-feeding and 79,9 % showed some evidence of malocclusion at the time of dental examination. There were significant differences for the following variables: sucking habits and malocclusion; breast-feeding time and sucking habits; breast-feeding time and malocclusion; type of feeding and sucking habits; and type of feeding and malocclusion. Dummy-sucking incidence was higher than that of finger-sucking in Brazilian children. Sucking habit incidence was higher in bottle-fed children than in breast-fed children. The relationship between incidence of habits and malocclusion was statistically significant.
Cattaneo, Adriano; Burmaz, Tea; Arendt, Maryse; Nilsson, Ingrid; Mikiel-Kostyra, Krystyna; Kondrate, Irena; Communal, Marie José; Massart, Catherine; Chapin, Elise; Fallon, Maureen
To assess progress in the protection, promotion and support of breast-feeding in Europe. Data for 2002 and 2007 were gathered with the same questionnaire. Of thirty countries, twenty-nine returned data for 2002, twenty-four for 2007. The number of countries with national policies complying with WHO recommendations increased. In 2007, six countries lacked a national policy, three a national plan, four a national breast-feeding coordinator and committee. Little improvement was reported in pre-service training; however, the number of countries with good coverage in the provision of WHO/UNICEF courses for in-service training increased substantially, as reflected in a parallel increase in the number of Baby Friendly Hospitals and the proportion of births taking place in them. Little improvement was reported as far as implementation of the International Code on Marketing of Breastmilk Substitutes is concerned. Except for Ireland and the UK, where some improvement occurred, no changes were reported on maternity protection. Due to lack of standard methods, it was difficult to compare rates of breast-feeding among countries. With this in mind, slight improvements in the rates of initiation, exclusivity and duration were reported by countries where data at two points in time were available. Breast-feeding rates continue to fall short of global recommendations. National policies are improving slowly but are hampered by the lack of action on maternity protection and the International Code. Pre-service training and standard monitoring of breast-feeding rates are the areas where more efforts are needed to accelerate progress.
Ehlayel, Mohammad S; Bener, Abdulbari
Exclusive breast-feeding (EBF) seems to reduce risk of allergies in the western countries, but there are few reports from developing countries. The purpose of this study was to assess the effect of EBF on the development of allergic diseases and eczema in a developing country. This is a cross-sectional survey done at the well-baby clinics of 11 primary health centers, Hamad Medical Corporation, Qatar. A multistage sampling design was used and a representative sample of 1500 children (0-5 years old) and mothers (18-47 years old) were surveyed between October 2006 and September 2007. Of them, 1278 mothers (85.2%) participated in the study. A confidential, anonymous questionnaire assessing breast-feeding and allergic diseases was completed by mothers bringing children for immunization. Questionnaire included allergic rhinitis, wheezing, eczema, type and duration of breast-feeding, parental smoking habits, number of siblings, family income, maternal education, and parental allergies. Univariate and multivariate statistical methods were performed for statistical analysis. More than one-half of the infants (59.3%) were on EBF. Length of breast-feeding was associated with maternal age. Prevalence of eczema (19.4%), allergic rhinitis (22.6%), and wheezing (12.7%) were significantly less frequent in those with prolonged (>6 months) compared with short-term fed infants. The association between EBF and eczema tended to be similar in children with a positive family history of atopy (p < 0.001) and eczema (p < 0.001) compared with those without. In children of developing countries, prolonged breast-feeding reduces the risk of developing allergic diseases and eczema even in the presence of maternal allergy, where it might be a practical, effective preventive measure.
Mezzacappa, Elizabeth S; Katlin, Edward S
Two studies examined the effects of breast-feeding on maternal stress and mood. In Experiment 1, perceived stress in the past month was compared between 28 breast-feeding and 27 bottle-feeding mothers. Breast-feeding mothers reported less perceived stress, after controlling for demographic confounds. In Experiment 2, mood ratings were assessed in the same 24 mothers both before and then after 1 breast-feeding and 1 bottle-feeding session. Breast-feeding was associated with a decrease in negative mood, and bottle-feeding was associated with a decrease in positive mood from pre- to postfeeding. Results indicated that breast-feeding buffers negative mood. These effects appeared to be attributable to the effects of breast-feeding itself and not solely to individual-differences factors.
Cattaneo, Adriano; Buzzetti, Roberto
Problem Breastfeeding rates and related hospital practices need improvement in Italy and elsewhere. Training of staff is necessary, but its effectiveness needs assessment. Context Eight hospitals in different regions of Italy. Design Controlled, non-randomised study. Data collected in three phases. Training after the first phase in group 1 hospitals and after the second phase in group 2. Strategies for change Training of trainers and subsequent training of health workers with a slightly adapted version of the 18 hour Unicef course on breastfeeding management and promotion. Key measures for improvement Hospital practices, knowledge of 571 health workers, and breastfeeding rates at discharge, three, and six months in 2669 mother and baby pairs. Effects of change After training hospitals improved their compliance with the “ten steps to successful breast feeding,” from an average of 2.4 steps at phase one to 7.7 at phase three. Knowledge scores of health professionals increased from 0.41 to 0.72 in group 1 (training after phase one) and from 0.53 to 0.75 in group 2 (after phase two). The rate of exclusive breast feeding at discharge increased significantly after training: 41% to 77% in group 1 and 23% to 73% in group 2, as did the rates of full (exclusive plus predominant) breast feeding at three months (37% to 50% in group 1 v 40% to 59% in group 2) and any breast feeding at six months (43% to 62% in group 1 v 41% to 64% in group 2). Lessons learnt Training for at least three days with a course including practical sessions and counselling skills is effective in changing hospital practices, knowledge of health workers, and breastfeeding rates. PMID:11739226
Inhaled therapies are preferred to systemic ones during pregnancy and breast feeding. A real paradox exists however between the necessity to ensure an optimal treatment for pregnant women with asthma, in order to prevent fetal hypoxia, and the precaution linked to any drug prescription during pregnancy. Thus, the use of topical corticosteroids remains the first choice for asthma as well as rhinitis. Inhaled beta2-agonists are also recommended. Systemic corticosteroids may however be prescribed without hesitation when their use is required for asthma treatment. It is also interesting to note that oral second-generation antihistamines are currently allowed during pregnancy and breast feeding. This type of antihistamines is indeed to be preferred to first-generation ones that generate more side-effects and generally are thus not to be prescribed during breast feeding.
Gubbels, Jessica S; Thijs, Carel; Stafleu, Annette; van Buuren, Stef; Kremers, Stef P J
The mechanisms underlying the protective effect of breast-feeding on the development of childhood overweight are unclear. This study examines the association of breast-feeding with weight gain in the first year, and body mass index (BMI) and overweight up to 4 years. In addition, we examine possible mechanisms of this effect (i.e., feeding pattern, eating style, unhealthy snacking behavior). Data originated from the KOALA Birth Cohort Study (N = 2 834). Questionnaires assessed breast-feeding duration up to 12 months, feeding pattern (i.e., feeding on demand or feeding to schedule) at 3 months, BMI at 1, 2 and 4 years, eating style (e.g., slow eating) at age 1, and unhealthy snacking at age 2. Linear and logistic regression analyses were used to examine the association of breast-feeding and feeding pattern with eating style, unhealthy snacking, BMI z-scores and overweight. Each additional month of breast-feeding was associated with less weight gain in the first year (regression coefficient B = -37.6 g, p < 0.001), a lower BMI z-score at age 1 (B = -0.02, p < 0.01), and a lower odds of being overweight at age 1 (odds ratio = 0.96, p < 0.05). Breast-feeding was associated with fewer unhealthy snacking occasions per week at age 2 (B = -0.19 for each month of breast-feeding, p < 0.001), but was unrelated to eating style. Feeding pattern was unrelated to all outcome variables after adjustment for breast-feeding duration. The study showed a short-term protective effect of breast-feeding against overweight development. Possible mechanisms through which breast-feeding may protect against overweight include less unhealthy snacking behavior, but not feeding pattern or child's eating style.
Wang, Wenru; Lau, Ying; Chow, Aloysius; Chan, Kin Sin
to (1) estimate the breast-feeding intention, initiation and duration rate; (2) identify the reasons to initiate and wean breast feeding and (3) explore predictors of breast-feeding duration. a prospective longitudinal study antenatal clinics of five regional hospitals from four clusters in Hong Kong a population-based sample of 2098 women in the second trimester of pregnancy was recruited with a systematic sampling method. three different sets of self-administered questionnaires were used to measure the breast-feeding intention, initiation and duration, demographic, socio-economic, obstetric, complications of pregnancy and intrapartum variables at three time points. Reasons for initiating and weaning breast feeding, the formal and informal supportive resources of participants during breast feeding were collated at the third time points. the rates of artificial feeding and breast feeding were 41.1% and 58.9%, whereas breast-feeding intention and initiation rates were 85.3% and 67.0%, respectively. The breast-feeding duration rates were 11.1%, 10.3%, 10.7% and 26.7%, for the 'within <1 week', '1-3 weeks', '>3-6 weeks' and '>6 weeks' groups. The common reasons for initiating breast feeding were that breast feeding is beneficial for both the baby (89.8%) and mother (39.7%). Reasons for weaning breast feeding were insufficient breast milk (32.7%), tiredness and fatigue (39.7%) and return to work (29.6%). Partner, relatives and nurse midwives were important supportive resource during breast feeding. Ordinal logistic regression analysis identified five predictive factors of breast-feeding duration. Participants who were working part-time or were housewives (p=0.037), had monthly family income of
Sarkar, Abdullah; Hashem, Alaa AbouBakr; Hamadah, Reem E; Alhoulan, Asma; AlMakadma, Yosra A; Khan, Tehreem A; Al-Hamdani, Abdurahman K; Senok, Abiola
Background The Baby Friendly Hospital Initiative (BFHI) is a practice guideline for healthcare providers to promote breastfeeding and increase breastfeeding rates. Objective This study aimed to examine reported experiences and views on breastfeeding of women using prenatal and postnatal services, and opinions of staff, in the context of the BFHI programme in Riyadh, Saudi Arabia. Design Prospective cohort study. Setting This prospective, longitudinal study was conducted from December 2013 to September 2015 at two healthcare facilities (BFHI and non-BFHI) in Riyadh Saudi Arabia. Methods Women 36–40 weeks gestation receiving antenatal care at the hospitals were enrolled. Questionnaires were administered prenatally, at 1, 3 and 6 months postnatal and to the administrator and maternity staff. Results We recruited 277 women with an estimated 80% response rate. 156 (BFHI=78/139, non-BFHI=78/138, 56%) participants completed all questionnaires. Most BFHI-hospital participants (77.9%, n=8 for this question) acknowledged seeing the breast feeding policy compared to 23.5% (n=23) at the non-BFHI-hospital (p<0.01). Breast feeding education and encouragement was higher at the BFHI-hospital (93.3%) compared to the non-BFHI-hospital (48.2%; p<0.01). At postpartum discharge, 51% (n=53) of mothers in the BFHI-hospital were breast feeding exclusively versus 29.6% (n=29) at the non-BFHI-hospital. Where formula feed was introduced, women in the BFHI-hospital more often practiced mixed feeding rather than exclusive formula feeding with some switching from mixed feeding to exclusive breast feeding between 3 and 6 months postpartum. Exclusive breast feeding rates declined in both hospitals at 3 and 6 months postpartum with lack of community services for lactation being a major reason. Although BFHI-hospital staff (n=9) were more conversant with BFHI principles, defects in adherence to the BFHI 10 Steps were identified. Conclusions This is the first study assessing the
Mosher, Cynthia; Sarkar, Abdullah; Hashem, Alaa AbouBakr; Hamadah, Reem E; Alhoulan, Asma; AlMakadma, Yosra A; Khan, Tehreem A; Al-Hamdani, Abdurahman K; Senok, Abiola
The Baby Friendly Hospital Initiative (BFHI) is a practice guideline for healthcare providers to promote breastfeeding and increase breastfeeding rates. This study aimed to examine reported experiences and views on breastfeeding of women using prenatal and postnatal services, and opinions of staff, in the context of the BFHI programme in Riyadh, Saudi Arabia. Prospective cohort study. This prospective, longitudinal study was conducted from December 2013 to September 2015 at two healthcare facilities (BFHI and non-BFHI) in Riyadh Saudi Arabia. Women 36-40 weeks gestation receiving antenatal care at the hospitals were enrolled. Questionnaires were administered prenatally, at 1, 3 and 6 months postnatal and to the administrator and maternity staff. We recruited 277 women with an estimated 80% response rate. 156 (BFHI=78/139, non-BFHI=78/138, 56%) participants completed all questionnaires. Most BFHI-hospital participants (77.9%, n=8 for this question) acknowledged seeing the breast feeding policy compared to 23.5% (n=23) at the non-BFHI-hospital (p<0.01). Breast feeding education and encouragement was higher at the BFHI-hospital (93.3%) compared to the non-BFHI-hospital (48.2%; p<0.01). At postpartum discharge, 51% (n=53) of mothers in the BFHI-hospital were breast feeding exclusively versus 29.6% (n=29) at the non-BFHI-hospital. Where formula feed was introduced, women in the BFHI-hospital more often practiced mixed feeding rather than exclusive formula feeding with some switching from mixed feeding to exclusive breast feeding between 3 and 6 months postpartum. Exclusive breast feeding rates declined in both hospitals at 3 and 6 months postpartum with lack of community services for lactation being a major reason. Although BFHI-hospital staff (n=9) were more conversant with BFHI principles, defects in adherence to the BFHI 10 Steps were identified. This is the first study assessing the effectiveness of BFHI implementation in Saudi Arabia. Although women
Hernández-González, Martha A; Díaz-De-León, Luz V; Guízar-Mendoza, Juan M; Amador-Licona, Norma; Cipriano-González, Marisol; Díaz-Pérez, Raúl; Murillo-Ortiz, Blanca O; De-la-Roca-Chiapas, José María; Solorio-Meza, Sergio Eduardo
Blood pressure levels in childhood influence these levels in adulthood, and breastfeeding has been considered such as a cardioprotective. We evaluated the association between blood pressure levels and feeding type in a group of infants. We conducted a comparative cross-sectional study in term infants with appropriate weight at birth, to compare blood pressure levels in those children with exclusively breastfeeding, mixed-feeding and formula feeding. The comparison of groups was performed using ANOVA and multiple regression analysis was used to identify variables associated with mean arterial blood pressure levels. A p value < 0.05 was considered significant. We included 20 men and 24 women per group. Infant Formula Feeding had higher current weight and weight gain compared with the other two groups (p < 0.05). Systolic, diastolic and mean blood pressure levels, as well as respiratory and heart rate were higher in the groups of exclusively formula feeding and mixed-feeding than in those with exclusively breastfeeding (p < 0.05). Multiple regression analysis identified that variables associated with mean blood pressure levels were current body mass index, weight gain and formula feeding. Infants in breastfeeding show lower blood pressure, BMI and weight gain.
New data on the quality and quantity of protein and nor-protein nitrogen in human milk are discussed in the first part of this review. The second part presents a short review of current knowledge on immunologically important components of human milk (secretory IgA, Lactoferrin, ligands for folic acid and vitamine B-12. Lysozyme, cells, induction of breast milk flora in the intestine). There are very good reasons to enhance breast feeding also in developed countries.
Dodd, S; Buist, A; Norman, T R
For every antidepressant so far investigated in the breast milk of mothers prescribed these medications, findings indicate that some amount of drug will be excreted into the breast milk. Nursing infants will be exposed to some, usually a very low, amount of drug and drug metabolites. Levels of drug exposure to infants for the many antidepressants available are examined, discussing milk to plasma drug concentration ratios and the infant dose as a percentage of the maternal dose. Drug concentrations in infant plasma and adverse effects of drug exposures to infants are reviewed. Factors influencing the decision on whether to breast or bottle feed an infant nursed by a mother taking antidepressants are discussed, concluding that the decision needs to be made on an individual basis. The lactating mother, in consultation with her doctor, should be in a position to make an informed decision on whether or not to breast feed. Under certain circumstances the decision to bottle feed may be wise, but more commonly the advantages of breast-feeding will outweigh the very low risk of an adverse event from drug exposure to the infant.
Geddes, Donna T; Chadwick, Lynda M; Kent, Jacqueline C; Garbin, Catherine P; Hartmann, Peter E
Coordination of infants' suck-swallow-breathing patterns is integral to safe and efficient feeding. However, assessment of these patterns is difficult and often invasive, particularly in breast-fed infants less than 4 months of age. The aims of this study were to develop an ultrasound approach to visualize swallowing in term breast-feeding infants and to determine the accuracy of ultrasound imaging of swallowing compared to respiratory inductive plethysmography (RIP). On ultrasound, the breast milk bolus was observed as a predominantly echogenic area moving inferiorly. Of the 388 swallows detected with ultrasound, 379 correlated with the swallow apneas detected by RIP (R(2) = 0.98). The mean duration of the swallow was 0.63 +/- 0.06 s. Ultrasound imaging is a noninvasive accurate method for detection of swallowing by visualization of movement of the milk bolus through the pharyngeal area of a breast-feeding infant. These techniques may potentially provide useful information for infants experiencing breast-feeding difficulties.
Noor, Sayeda Z; Rousham, Emily K
To explore the relationship between infant feeding and maternal mental well-being among women of Bangladeshi and Pakistani ethnicity; and to explore the sources of advice, information and support available to women before and after childbirth. A cross-sectional survey of infant feeding and maternal well-being via structured interviews conducted in the home. Home visits within two inner-city wards of Newcastle upon Tyne. Eighty-six women of South Asian ethnicity. Enjoyment of everyday activities was higher among women who breast-fed only (P = 0.028); whereas feeling sad or crying during pregnancy was lower among breast-feeding women (P = 0.005), as was not sleeping well (P = 0.003) and feeling that everything was too much (P = 0.039), compared with women who used formula or mixed feeding. Women who breast-fed only had better mean mood scores than those who formula-fed or those who both breast-fed and formula-fed (P < 0.001). Mean mood responses were also significantly associated with the mother's level of understanding of English and number of years in education (P = 0.005 and P = 0.003, respectively). The association between method of feeding and maternal mood remained strong after controlling for the effects of English language and maternal education. The study suggests that breast-feeding may be an important mediator of maternal mental well-being after childbirth. Community-based programmes tailored to the needs of Bangladeshi and Pakistani women which support breast-feeding and encourage exclusive breast-feeding may be of benefit.
Fitzsimons, Emla; Vera-Hernández, Marcos
To compare the incidence of breast feeding by day of week of birth. Retrospective database study using 16 508 records from the 2005 and 2010 Infant Feeding Surveys. England and Wales, UK. Mothers of a sample of births from among all registered births in the periods August-September 2005 and August-October 2010. Incidence of breast feeding after birth. Among babies of mothers who left full-time education aged 16 or under, the incidence of breast feeding was 6.7 percentage points lower (95% CI 1.4 to 12.1 percentage points) for those born on Saturdays than for those born on Mondays-Thursdays. No such differences by day of week of birth were observed among babies of mothers who left school aged 17 or over. Breastfeeding policy should take into account differences in breast feeding by day of week of birth, which are apparent among low-educated mothers. Further research is needed to ascertain the reason for this finding. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/
Jones, R E
The association between breast-feeding patterns and resumption of menses post-partum was examined in a prospective study in Indonesia. In order to examine these relationships directly in a longitudinal study, it was first necessary to distinguish among women who experienced infant mortality before menses resumed, women who weaned before menses resumed, and women who had return to menses while breast-feeding. Information on suckling patterns and menstrual status was collected by recall for 444 women at monthly visits for 2 years. Three main breast-feeding variables, minutes per episode, number of episodes per day, number of episodes per night, and other breast-feeding variables were derived for each woman, to give the average nursing pattern up to menses or the end of the study, which-ever came first. While high levels of nursing for each of these three main variables were found to be significantly related to delay in return of menses post-partum, the interactions between more minutes per episode, and more frequent day- and night-time feeds, were found to be the most important factors in the delay in onset of post-partum menstruation in those women whose menses resumed while still nursing or who remained amenorrhoeic and nursing at the end of the study.
Fitzsimons, Emla; Vera-Hernández, Marcos
Objective To compare the incidence of breast feeding by day of week of birth. Design Retrospective database study using 16 508 records from the 2005 and 2010 Infant Feeding Surveys. Setting England and Wales, UK. Participants Mothers of a sample of births from among all registered births in the periods August–September 2005 and August–October 2010. Main outcome measure Incidence of breast feeding after birth. Results Among babies of mothers who left full-time education aged 16 or under, the incidence of breast feeding was 6.7 percentage points lower (95% CI 1.4 to 12.1 percentage points) for those born on Saturdays than for those born on Mondays–Thursdays. No such differences by day of week of birth were observed among babies of mothers who left school aged 17 or over. Conclusions Breastfeeding policy should take into account differences in breast feeding by day of week of birth, which are apparent among low-educated mothers. Further research is needed to ascertain the reason for this finding. PMID:27401354
Joseph, Heather M; Emery, Rebecca L; Bogen, Debra L; Levine, Michele D
Understanding factors related to breast-feeding intention, initiation, duration, and weaning among women who quit smoking as a result of pregnancy may inform interventions to increase breast-feeding rates among women who smoke. Women (N = 300) who quit smoking as a result of pregnancy and enrolled in a postpartum relapse prevention trial were interviewed about breast-feeding intention prior to delivery. Breast-feeding initiation, duration, reasons for weaning, and relapse to smoking were assessed at 12-weeks postpartum. The majority of pregnant former smokers intended to breastfeed (68%), and actual rates of breast feeding were higher (74%). Among women who initiated breast feeding, weaning before 2 months was common (41%). For most women (69%), smoking had no effect on breast-feeding decisions. Among the 31% of women who reported that smoking influenced their feeding decisions, 83% indicated that they did not smoke or decreased smoking frequency in order to breastfeed while 17% did not breastfeed or quit breast feeding in order to smoke. Women who decided to forgo breast feeding to smoke were significantly more likely to have a high school education or less (p < .001) and to be African American (p < .0001) than those who had other reasons not to breastfeed. Most women who quit smoking during pregnancy initiate breast feeding, and the majority report smoking did not influence feeding decisions. Importantly, among women for whom smoking did influence feeding decisions, most reported changing smoking behavior to enable breast feeding. Interventions to increase breast-feeding initiation and duration may decrease postpartum relapse and improve maternal and infant health. This study extends the literature on women's perception of the influence of smoking on breast feeding by assessing breast-feeding intent, initiation, duration, and reasons for weaning longitudinally among women who quit smoking as a result of pregnancy. The results support a need for additional
The author gives her views on some of the problems of baby-feeding support in the community. There appear to be inconsistencies in the way "breast-feeding" is defined, which can lead to confusing data and may inflate the figures for hospital breast-feeding rates. Early discharge of mothers after a birth and shortage of community midwives make it more difficult for mothers to establish breast-feeding. Support for both breast-feeding and bottle-feeding mothers is often lacking. The author describes an inclusive support group that welcomes mothers whether they are exclusively breast-feeding, partially breast-feeding, or bottle feeding.
Robinson, Karen M; VandeVusse, Leona
Examining prenatal breast-feeding self-efficacy and infant feeding decisions among African American women using a mixed-method approach. A black feminist philosophy was used to keep women's experiences as the central research focus. The Prenatal Breast-feeding Self-efficacy Scale was used to determine differences between intended breast-feeders and formula users among 59 women. Seventeen narrative interviews were conducted to analyze postpartum accounts of actual feeding practices. Both groups (intended breast- or formula-feeders) demonstrated confidence in their ability to breast-feed. Women planning to breast-feed (M = 82.59, SD = 12.53) scored significantly higher than anticipated formula users (M = 70, SD = 15.45), P = .001 (2-tailed). Four of the six themes emerging from narrative analysis were similar to categories of self-efficacy: performance accomplishments, vicarious experiences, verbal persuasions, and physiological reactions. In addition, themes of social embarrassment and feelings of regret were identified. Although African American women in this study rated themselves overall as confident with breast-feeding, several narratives about actual feeding choices indicated ambivalence. Women planning to breast-feed need continued support from their healthcare providers throughout the childbearing year. Furthermore, prenatal and immediate postpartum opportunities may exist for nurses to encourage breast-feeding among individuals who initially plan formula use.
Radius, S M; Joffe, A
This study was designed to assess the benefits and barriers accruing to breast-feeding as perceived by pregnant adolescents, and to establish whether these perceptions distinguished between adolescent mothers who chose to breast versus bottle feed. Surveys were completed by 254 young women attending prenatal clinics. Overall, 19.3% indicated their intent to breast-feed. When categorized by intended method of infant feeding (breast versus bottle), breast-feeding mothers cited more benefits and fewer barriers associated with that method of infant feeding. Overall, perceived benefits were more successful than perceived barriers in distinguishing between the groups of respondents. For those interested in promoting breast-feeding among adolescent mothers, our data support an emphasis on the diverse benefits of this method of infant feeding. Our results also suggest the usefulness of peer role models in correcting misinformation and encouraging breast-feeding among adolescent mothers.
FISHER, JENNIFER ORLET; BIRCH, LEANN LIPPS; SMICIKLAS-WRIGHT, HELEN; PICCIANO, MARY FRANCES
Objective Current recommendations for infant feeding encourage breast-feeding through the first year. This research was conducted to evaluate associations among breast-feeding, maternal control of child feeding, and the dietary intake of toddlers during the second year of life. In particular, we sought to determine whether breast-feeding through the first year and subsequent toddler intake was mediated via maternal control of child feeding. Design/subjects Fifty-five white infants and their mothers were monitored longitudinally from age 12 or 13 months to age 18 months. Main outcome measures Breast-feeding through the first year and maternal control in infant feeding were evaluated as predictors of energy intake at age 18 months. Statistical analyses performed Regression analysis was used to evaluate predictors of toddler energy intake at age 18 months. A mediation model tested if the relationship between breast-feeding and infant intake was mediated by maternal control in feeding. Results Breast-feeding through the first year was associated with higher toddler energy intakes at age 18 months through its influence on maternal control in feeding. Mothers who breast-fed their infants for at least 12 months used lower levels of control in feeding. Lower levels of maternal control in feeding were associated with higher toddler energy intakes. The highest energy intakes among children aged 18 months were observed among taller and leaner toddlers. Applications/conclusions Our findings suggest that breast-feeding through the first year may have an effect on children’s energy intake by shaping mothers’ child-feeding practices. These findings may be used by clinicians to assist parents in making informed decisions about choice of infant-feeding method and to provide anticipatory guidance regarding infant-feeding style when initiating dietary diversity. PMID:10863566
Mueffelmann, Rebecca E; Racine, Elizabeth F; Warren-Findlow, Jan; Coffman, Maren J
Breastfeeding intention is a significant predictor of initiation and duration. The decision to breastfeed may be influenced by the opinions of family and friends. This study aimed to examine the relationship between maternal perception of the infant feeding preferences of the baby's father and the maternal grandmother and the woman's intention to breastfeed. This study analyzed data from the Infant Feeding Practices Survey II (2005-2007). The sample included 4690 women, of whom approximately 82% were white, 67% were married, 68% were multiparous, and 66% had some college education or beyond. In adjusted analyses, the odds of intending to exclusively breastfeed in the first few weeks postpartum were higher among mothers who perceived that the baby's father or the maternal grandmother preferred exclusive breastfeeding (vs preferred other feeding) (fathers: odds ratio [OR] = 7.44; 95% confidence interval [CI], 6.20-8.92; maternal grandmothers: OR = 2.45; 95% CI, 2.01-2.99). Mothers in each of the racial/ethnic groups examined were more likely to intend to exclusively breastfeed in the first few weeks postpartum if they perceived that the expectant father preferred exclusive breastfeeding (vs preferred other feeding methods) (white: OR = 7.67; 95% CI, 6.25-9.41; black: OR = 11.76; 95% CI, 4.85-28.51; Hispanic: OR = 7.01; 95% CI, 3.44-14.28; other: OR = 7.51; 95% CI, 3.39-16.67). These results suggest that significant family members should be counseled on the benefits of breastfeeding and the risks of formula feeding along with pregnant mothers. © The Author(s) 2014.
Gupta, Mukesh; Zaheer; Jora, Rakesh; Kaul, Vijay; Gupta, Rajeev
To evaluate the influence of early infancy feeding practices on fasting insulin levels, as marker of insulin resistance, in low birthweight neonates. Eighty successive low birth weight (<2.5 kg) neonates <10 days of age born at >38 wk of gestation at this tertiary care centre, were successively invited for participation in the study; parents of 52 (65%) consented to participate. Group 1 children (n=26) were randomized to receive only breast feeding and Group 2 (n=26) received fortified breast feeding with a commercially available human milk fortifier. Routine anthropometry and evaluation of health status was performed. The babies were followed-up every 15 day up to three months. 4-hour fasting glucose and insulin levels were measured at baseline and at 3 month. Statistical analyses were performed using t-test and Mann-Whitney test. In excusively breast-fed Group 1 neonates vs Group 2 the mean birthweight was similar (1.99+/-0.23 vs 1.87+/-0.30 kg). There was no difference in body length, head circumference and chest circumference. Mean hemoglobin levels, fasting glucose (63.9+/-9.8 vs 64.3+/-8.0 mg/dl) and fasting insulin levels (1.44+/-1.19 vs 1.73+/-1.38 microU/ml), were also similar. At three month follow-up in Group 1 children receiving exclusive breast feeding, there was significantly lower weight as compared to Group 2 (3.40+/-0.3 vs 4.75+/-0.5 kg, p<0.01). This was associated with significantly lower fasting glucose (79.0+/-9.4 vs 85.6+/-8.4 mg/dl) and fasting insulin levels (6.95+/-4.27 vs 15.73+/-3.29 microU/ml) (p<0.001). The difference persisted even after adjustment for weight gain in Group 2 (weight adjusted insulin 11.26+/-3.3 microU/ml; p<0.001). Low birthweight neonates fed fortified breast milk had greater fasting insulin levels compared to those with exclusive breast feeding, at three month of age. The difference persisted after adjustment for excessive gain in fortified milk fed neonates and, suggests adverse glucometabolic programming.
Ricke, Lori A; Baker, Nancy J; Madlon-Kay, Diane J; DeFor, Terese A
The purposes of this study were: (1) to determine whether breast-fed infants with tongue-tie have decreased rates of breast-feeding at 1 week and 1 month of age, (2) to determine the prevalence of tongue-tie, and (3) to test the usefulness of the Assessment Tool for Lingual Frenulum Function (ATLFF) in assessing the severity of tongue-tie in breast-feeding newborns. A case-control design was used. All infants in the Regions Hospital newborn nursery were examined for tongue-tie. Tongue-tied babies were examined using the ATLFF. Two breast-feeding babies with normal tongues were identified and matched for each case. Mothers were interviewed when the babies were 1 week and 1 month old. The prevalence of tongue-tie was 4.2%. Forty-nine tongue-tied and 98 control infants were enrolled. Tongue-tied babies were 3 times as likely as control babies to be bottle fed only at 1 week [risk ratio (RR), 3.11; 95% confidence interval (CI), 1.21, 8.03) By 1 month, tongue-tied babies were as likely as controls to be bottle fed only. (RR, 1.00; 95% CI, 0.55, 1.82) Twelve of the tongue-tied infants had ATLFF scores of "Perfect," none had scores of "Acceptable," and 6 had scores of "Function Impaired." The remaining 31 infants had scores that fell into none of these categories. Tongue-tie is a relatively common condition in newborns. Affected infants are significantly more likely to be exclusively bottle-fed by 1 week of age. The ATLFF was not a useful tool to identify which tongue-tied infants are at risk for breast-feeding problems.
Groenwold, R H H; Tilling, K; Moons, K G M; Hoes, A W; van der Ent, C K; Kramer, M S; Martin, R M; Sterne, J A C
Estimated effects of breast-feeding on childhood health vary between studies, possibly due to confounding by baseline maternal and child characteristics. Possible time-dependent confounding has received little consideration. Our aim was to evaluate the impact of such confounding. We estimated the relationship between cumulative exclusive breast-feeding up to 6 months and wheezing, rash and body mass index (BMI) at 12 months [in the Whistler cohort (n = 494) and PROBIT (n = 11,463)], and wheezing, rash, asthma, hay fever, eczema, allergy and BMI at age 6.5 years (PROBIT). We adjusted for time-dependent confounding by weight, length, rash, respiratory illness and day care attendance using marginal structural models (MSMs). Weight and day care attendance appeared potential time-dependent confounders, since these predicted breast-feeding status and were influenced by previous breast-feeding. However, adjustment for time-dependent confounders did not markedly change the estimated associations. For example, in PROBIT the adjusted increase in BMI at 12 months per 1-month increase in exclusive breast-feeding was 0.04 (95% CI -0.09 to 0.01) using logistic regression and -0.06 (95% CI -0.11 to -0.01) using MSM. In Whistler, these estimates were each -0.05 (95% CI -0.10 to 0.00). In two cohort studies, there was little evidence of time-dependent confounding by weight, length, rash, respiratory illness or day care attendance of the effects of breast-feeding on early childhood health. © 2014 S. Karger AG, Basel.
Flacking, Renée; Hellström-Westas, Lena
Objective There are indications that the prevalence of exclusively breastfed preterm infants is decreasing in Sweden. The objective was to investigate trends in exclusive breast feeding at discharge from Swedish neonatal units and associated factors in preterm infants. Design, setting and participants This is a register study with data from the Swedish Neonatal Quality Register. Data from 29 445 preterm infants (gestational age (GA) <37 weeks) who were born during the period 2004–2013 were retrieved. Data included maternal, perinatal and neonatal characteristics. Data were analysed for the whole population as well as for 3 GA groups. Results From 2004 to 2013, the prevalence of exclusive breast feeding decreased, in extremely preterm (GA 22–27 weeks) from 55% to 16%, in very preterm (GA 28–31 weeks) from 41% to 34% and in moderately preterm infants (GA 32–36 weeks) from 64% to 49%. The decline was statistically significant (p<0.001) in all 3 GA groups. This decline remained significant when adjustments were made for factors negatively associated with exclusive breast feeding and which became more prevalent during the study period, that is, small for GA (all groups) and maternal mental illness (very preterm and moderately preterm infants). Conclusions In the past 10 years, Sweden has experienced a lower rate of exclusive breast feeding in preterm infants, especially in extremely preterm infants. The factors analysed in this study explain only a small proportion of this decline. The decline in exclusive breast feeding at discharge from neonatal units raises concern and present challenges to the units to support and promote breast feeding. PMID:27965252
Gulino, C; Sweeney, M A
Too few Mexican and Mexican-American mothers breast feed their babies. Results of a study of breast-feeding attitudes in Tijuana and San Diego point to the need for education, guidance, and support at the community level if more young mothers in this population are to give their newborns the advantages of breast feeding.
Guedes, H T V; Souza, L S F
The aim of this study was to evaluate the interaction between the exclusive breast-feeding protective effect and the exposure to tobacco smoke at domicile in the first year of life, on the onset of respiratory allergy (asthma and rhinitis) in children until 5 yr of age. This is prospective cohort study, observational, institutional based. Three hundred children born in a public hospital of Salvador-Bahia (Brazil) were followed from birth to 5 yr of age. Data from 268 children at 60 months of life were analyzed. Occurrence of allergic symptoms were studied and correlated with gender, allergic relatives in first degree, exclusive breast-feeding duration, smoking mother, and presence of other smoker at home, considering the first year of life. Exclusive breast-feeding for at least 6 months showed a protection effect against the onset of respiratory allergy in children from birth to 5 yr (p < 0.05); odds ratio (OR): 0.33 (95% CI: 0.18-0.59). Breast-fed children for less then 6 months compared with those breast-fed for 6 months or more, presented a higher risk (OR: 2.34-95% CI: 1.4-3.74) for developing allergic respiratory symptoms just to 5 yr. The protective effect of exclusive prolonged breast-feeding on the onset of respiratory allergy in children from birth until 5 yr was lost when their mothers were smokers (OR: 2.50-95% CI 1.19-5.19). Therefore, the protective effect of breast-feeding in the first year of life on the onset of allergic symptoms until the age of 5 yr was confirmed. This study proposes a confounding effect of maternal smoking on this protection, exposed by a higher risk for present allergic symptoms until the age of 5 yr, in children exclusively breast-fed for 6 months or more, when their mothers smoked.
Turok, David K; Leeman, Lawrence; Sanders, Jessica N; Thaxton, Lauren; Eggebroten, Jennifer L; Yonke, Nicole; Bullock, Holly; Singh, Rameet; Gawron, Lori M; Espey, Eve
Immediate postpartum levonorgestrel intrauterine device insertion is increasing in frequency in the United States, but few studies have investigated the effect of early placement on breast-feeding outcomes. This study examined the effect of immediate vs delayed postpartum levonorgestrel intrauterine device insertion on breast-feeding outcomes. We conducted this noninferiority randomized controlled trial at the University of Utah and the University of New Mexico Health Sciences Centers from February 2014 through March 2016. Eligible women were pregnant and planned to breast-feed, spoke English or Spanish, were aged 18-40 years, and desired a levonorgestrel intrauterine device. Enrolled women were randomized 1:1 to immediate postpartum insertion or delayed insertion at 4-12 weeks' postpartum. Prespecified exclusion criteria included delivery <37.0 weeks' gestational age, chorioamnionitis, postpartum hemorrhage, contraindications to levonorgestrel intrauterine device insertion, and medical complications of pregnancy that could affect breast-feeding. We conducted per-protocol analysis as the primary approach, as it is considered the standard for noninferiority studies; we also report the alternative intent-to-treat analysis. We powered the study for the primary outcome, breast-feeding continuation at 8 weeks, to detect a 15% noninferiority margin between groups, requiring 132 participants in each arm. The secondary study outcome, time to lactogenesis, used a validated measure, and was analyzed by survival analysis and log rank test. We followed up participants for ongoing data collection for 6 months. Only the data analysis team was blinded to the intervention. We met the enrollment target with 319 participants, but lost 34 prior to randomization and excluded an additional 26 for medical complications prior to delivery. The final analytic sample included 132 in the immediate group and 127 in the delayed group. Report of any breast-feeding at 8 weeks in the immediate
Kind, C; Schubiger, G; Schwarz, U; Tönz, O
It has been shown that altering hospital policies in a way to avoid interference of routine prescriptions with initiation of breast feeding and to provide active encouragement to mothers and personnel can result in significant benefit for later breast feeding success. It is less clear, however, which of the elements of a promotional programme such as UNICEF/WHO's "ten steps to successful breast feeding" are absolutely essential and which can be adapted to local cultural habits. We performed an open randomized multicenter study in Switzerland to evaluate, whether restriction of supplementary fluids for breast fed infants in the first week of life and strict avoidance of artificial teats and pacifiers affects later breast feeding success. Follow up to 6 months was ensured by mailed questionnaires. 602 mother infant pairs were enrolled. Of 294 infants in the intervention group 39% were excluded from the final analysis because of protocol violations, mainly maternal request for the use of pacifiers or bottles. Though the number of dextrin maltose supplements during the first two days (1.7 vs. 2.2 on day 1, 2.2 vs. 2.6 on day 2) and the percentage of infants receiving any supplement (85% vs. 96.6%) was significantly smaller in the intervention group, the difference was disappointingly small. The prevalence of breast feeding was 100% vs. 99% at day 5, 88% vs. 88% at 2 months, 75% vs. 71% at 4 months and 57% vs. 55% at 6 months, none of the differences being significant. We conclude that rigorous adherence to all of the ten steps may encounter obstinate resistance from cultural habits even in a population highly favourable to breast feeding. An improvement in adherence does not necessarily lead to better breast feeding success. The results of the few comparable studies in the literature show also that cultural practices during the first months of life may influence profoundly the long term effects of interventions during the first days of life.
Navarro-Estrella, Manuel; Duque-López, María Ximena; Trejo y Pérez, Juan Antonio
To identify the maternal, work, and health services factors associated with a short duration of breast-feeding in working mothers. A cross-sectional study was carried out between November 1998 and March 1999, among 265 mothers medically insured by (Instituto Mexicano del Seguro Social, IMSS) Mexican Institute of Social Security, who completed a questionnaire when their babies were 3 to 9 months old. Mothers were divided into two groups, based on breast-feeding duration: those who breast-fed for less than 3 months and those who did so for three months or more. Logistic regression was used to identify the factors associated with short duration of breast-feeding. One-hundred and twelve mothers (42.3%) abandoned breast-feeding early. Risk factors were: poor maternal knowledge on breast-feeding, odds ratio (OR) 5.97, 95% confidence interval (CI) 1.67-20.67; mothers with no previous breast-feeding experience OR 2.98, 95% CI 1.66-5.36; mothers planning to breast-feed their babies for less than 3 months (OR 16.24, 95% CI 5.37-49.12); and mothers with no access to breast-feeding facilities at work (OR 1.99, 95% CI 1.12-3.56). The main factors associated with short duration of breast-feeding were the maternal ones. The only work-related factor associated with short duration of breast-feeding was the absence of breast-feeding facilities. It is probable that maternal knowledge on breast-feeding, previous breast-feeding experience, and the availability of facilities at work for breast-feeding affect the maternal decisions on breast-feeding duration.
Bentley, Margaret E; Corneli, Amy L; Piwoz, Ellen; Moses, Agnes; Nkhoma, Jacqueline; Tohill, Beth Carlton; Ahmed, Yusuf; Adair, Linda; Jamieson, Denise J; van der Horst, Charles
A neglected issue in the literature on maternal nutrition and HIV is how HIV-positive women perceive their own bodies, health, and well-being, particularly in light of their infection, and whether these perceptions influence their infant feeding practices and their perceived ability to breast-feed exclusively through 6 mo. We conducted formative research to better understand breast-feeding practices and perceptions, and to inform the Breastfeeding, Antiretroviral, and Nutrition (BAN) Study, a clinical trial to evaluate antiretroviral and nutrition interventions to reduce mother-to-child transmission of HIV during breast-feeding in Lilongwe, Malawi. Twenty-two HIV-positive women living in semi-rural areas on the periphery of Lilongwe participated in in-depth interviews. In an adaptation of the body-silhouette methodology, nine culturally appropriate body silhouettes, representing a continuum of very thin to very large shapes, were used to elicit women's views on their present, previous-year, and preferred body shapes, and on the shape they perceived as healthy. The narrative scenario method was also used to explore women's views on 2 fictional women infected with HIV and their ability to exclusively breast-feed. Women perceived larger body shapes as healthy, because fatness is considered a sign of good health and absence of disease, and many recognized the role of nutrition in achieving a preferred or healthy body shape. Several women believed their nutritional status (body size) was declining because of their illness. Women were concerned that breast-feeding may increase the progression of HIV, suggesting that international guidelines to promote appropriate infant feeding practices for infants whose mothers are infected with HIV should focus on the mother's health and well-being, as well as the infant's.
Hanson, Michelle B.; Hellerstedt, Wendy L.; Desvarieux, Moise; Duval, Susan J.
Objective: To examine the associations of education and employment with breast-feeding initiation and duration in rural mothers, in the context of environmental, social, and intrapersonal factors. Methods: Data from a telephone survey of 414 mothers from rural Minnesota were examined with regression analyses. Results: Education and employment had…
Hanson, Michelle B.; Hellerstedt, Wendy L.; Desvarieux, Moise; Duval, Susan J.
Objective: To examine the associations of education and employment with breast-feeding initiation and duration in rural mothers, in the context of environmental, social, and intrapersonal factors. Methods: Data from a telephone survey of 414 mothers from rural Minnesota were examined with regression analyses. Results: Education and employment had…
Bedinghaus, J M
Primary care physicians can integrate care of the breasts through a woman's life cycle. Early and frequent nursing and careful attention to the infant's suckling position during the postpartum period can prevent several common problems. Neonatal jaundice, poor weight gain, mastitis, and candidiasis should be recognized and managed correctly. Outside the puerperium, fibrocystic change, nonlactational mastitis, and benign breast masses are encountered commonly. Problems related to silicone augmentation are discussed briefly.
Breast-feeding is a key public health target but social and cultural factors are often overlooked when encouraging mothers to choose breast-feeding as their method of infant feeding. Historically, there have always been some mothers who have sought alternatives to breast-feeding. Age, level of education and occupation impact upon a mother's choice, and the sexualization of the female breast can lead to embarrassment when mothers breast-feed outside the home. Fear of damaging their body shape can prevent some mothers from breast-feeding, while others see breast-feeding as desirable as it can lead to weight loss. The attitudes of partners, relatives and friends can influence mothers to varying degrees in their choice of infant feeding. Knowledge of various influences can assist health professionals in their public health role and help them to give mothers advice relevant to their circumstances.
Hanson, Lars A; Korotkova, Marina; Telemo, Esbjörn
Breast-feeding provides many advantages to the offspring, but presently there is an ongoing debate whether or not it prevents allergy any better than certain formulas. This report reviews the mechanisms involved and discusses how breast-feeding may protect against allergy. The review builds on an internet-based literature search in addition to our own data. Human milk is the food best adapted to the needs of the offspring, also because it provides efficient protection against infections and actively stimulates the development of the infant's own immune system. The major host defense system is provided via the secretory IgA antibodies produced in the mammary glands by lymphocytes, which have migrated there from the mother's gut mucosa. Therefore, these antibodies in the milk are primarily directed against the microbes in the mother's gut and her food proteins. As a result, breast-feeding starting directly after delivery will provide an excellent defense against the microbes normally meeting the neonate and needed to induce development of its immune system. The milk also contains numerous components, which seem to enhance the infant's host defense as well as capacity to develop tolerance, helping to avoiding allergic reactivity to foods, etc. Several studies show that breast-feeding prevents allergic diseases, but there are also good disagreeing studies. Supported by animal data, it seems that protection is enhanced in areas with more advantageous fat intake, inter alia lower ratio of n-6/n-3 fatty acids. Breast-feeding seems to protect against future development of allergic diseases, but possibly less so in countries with an untoward maternal fat intake.
Sacker, A; Kelly, Y; Iacovou, M; Cable, N; Bartley, M
To investigate the association between breast feeding and intergenerational social mobility and the possible mediating role of neurological and stress mechanisms. Secondary analysis of data from the 1958 and the 1970 British Cohort Studies. Longitudinal study of individuals born in Britain during 1 week in 1958 and 1970. 17 419 individuals participated in the 1958 cohort and 16 771 in the 1970 cohort. The effect of breast feeding on intergenerational social mobility from age 10/11 to age 33/34 was analysed after multiple imputations to fill in missing data and propensity score matching on a wide range of confounders measured in childhood (1958 cohort N=16 039-16 154; 1970 cohort N=16 255-16 361). Own Registrar General's Social Class (RGSC) at 33/34 years adjusted for father's RGSC at 10/11 years, gender and their interaction. Breastfed individuals were more likely to be upwardly mobile (1958 cohort: OR 1.24 95% CI 1.12 to 1.38; 1970 cohort: OR 1.24 95% CI 1.12 to 1.37) and less likely to be downwardly mobile (1958 cohort: OR 0.81 95% CI 0.73 to 0.90; 1970 cohort: OR 0.79 95% CI 0.71 to 0.88). In an ordinal regression model, markers of neurological development (cognitive test scores) and stress (emotional stress scores) accounted for approximately 36% of the relationship between breast feeding and social mobility. Breast feeding increased the odds of upward social mobility and decreased the odds of downward mobility. Consistent with a causal explanation, the findings were robust to matching on a large number of observable variables and effect sizes were alike for two cohorts with different social distributions of breast feeding. The effect was mediated in part through neurological and stress mechanisms.
Sacker, A; Kelly, Y; Iacovou, M; Cable, N; Bartley, M
Objective To investigate the association between breast feeding and intergenerational social mobility and the possible mediating role of neurological and stress mechanisms. Design Secondary analysis of data from the 1958 and the 1970 British Cohort Studies. Setting Longitudinal study of individuals born in Britain during 1 week in 1958 and 1970. Participants 17 419 individuals participated in the 1958 cohort and 16 771 in the 1970 cohort. The effect of breast feeding on intergenerational social mobility from age 10/11 to age 33/34 was analysed after multiple imputations to fill in missing data and propensity score matching on a wide range of confounders measured in childhood (1958 cohort N=16 039–16 154; 1970 cohort N=16 255–16 361). Main outcome measures Own Registrar General's Social Class (RGSC) at 33/34 years adjusted for father's RGSC at 10/11 years, gender and their interaction. Results Breastfed individuals were more likely to be upwardly mobile (1958 cohort: OR 1.24 95% CI 1.12 to 1.38; 1970 cohort: OR 1.24 95% CI 1.12 to 1.37) and less likely to be downwardly mobile (1958 cohort: OR 0.81 95% CI 0.73 to 0.90; 1970 cohort: OR 0.79 95% CI 0.71 to 0.88). In an ordinal regression model, markers of neurological development (cognitive test scores) and stress (emotional stress scores) accounted for approximately 36% of the relationship between breast feeding and social mobility. Conclusions Breast feeding increased the odds of upward social mobility and decreased the odds of downward mobility. Consistent with a causal explanation, the findings were robust to matching on a large number of observable variables and effect sizes were alike for two cohorts with different social distributions of breast feeding. The effect was mediated in part through neurological and stress mechanisms. PMID:23798701
Strom, S S; Baldwin, B J; Sigurdson, A J; Schusterman, M A
Saline breast implants have been used for the past 30 years for cosmetic and reconstructive purposes. Data based on a large number of patients are needed to evaluate patient satisfaction, cancer screening practices, problems associated with breast-feeding, and health effects. We conducted a follow-up study of 292 cosmetic saline breast implant patients from Texas and Louisiana who consented to a telephone interview. Using a Likert scale, we measured the patients' degree of satisfaction with the implants. The results indicated that 80.5 percent were satisfied, 73.3 percent would recommend saline breast implants to others, and 65.1 percent felt that implants improved their quality of life. The extent of satisfaction was independent of the number of additional surgeries, age at implant, and follow-up time. Mammography use and breast self-examination were reported with high frequency in this survey. Ninety-one percent of study participants who were between 40 and 49 years of age at time of interview and 94 percent of those 50 or older reported having had at least one mammogram. Breast self-examination was practiced by 75 percent of the women, and 61 percent reported checking their breasts at least once a month. Of the 46 women who had children after augmentation, 28 reported breast-feeding and 8 (28.6 percent) reported having implant-related problems. The patients were asked to provide information regarding a series of conditions for which they sought medical attention. They reported: atypical rheumatoid syndrome (n = 1), Sjögren syndrome (n = 1), atypical autoimmune disorder (n = 1), and chronic fatigue syndrome (n = 2). Overall, women who elected to have saline breast implants were satisfied with their augmentations, had mammograms and performed breast self-examinations more often than nonaugmented women. A few had problems when breast-feeding that could be related to their implants. There were no reports of breast cancer, but five women reported autoimmune
Jang, Gun Ja; Lee, Sang Lak; Kim, Hyeon Mi
This study was done to compare breast feeding rates and factors influencing feeding practice between late preterm (34 ≤ GA < 37) and preterm infants (GA<34). A survey was done of 207 late preterm and 117 preterm infants in neonatal intensive care units (NICU) of 4 university hospitals in D city. Data were collected from July 2009 to June 2010 from 324 medical records in the NICU. Breast-feeding at home was checked either by telephone survey or questioning during hospital visits. Rate of breast feeding for late preterm infants was significantly lower than for preterm infants. There was no significant difference in breast-feeding at home. We found differences in factors influencing breast feeding between the two groups. Factors influencing feeding for late preterm infants were type of delivery, mothers' occupation, feeding type during hospitalization, time elapse from hospital discharge, total admission days, infant's body weight at first feeding and length of NPO (nothing by mouth). Factors influencing feeding for preterm infants were birth order, maternal disease and obstetric complications, and one-minute Apgar score. Results of the study show low rates of breast-feeding for late preterm infants indicating a need for breast-feeding education for mothers of these infants.
Ukwuani, F A; Suchindran, C M; Cornwell, G T
This study uses data from the Nigerian Demographic and Health Survey collected in 1990 and the Ugandan Demographic and Health Survey collected in 1995 to examine the implications of mother's work, childhood place of residence, and exposure to the media for breast-feeding patterns (exclusivity and intensity) in Nigeria and Uganda. Nigeria and Uganda present an interesting contrast because Nigeria is more modernized and economically developed than Uganda, thus providing a good indication of the influence of modernization on breast-feeding patterns. Mother's work status is defined by considering whether mothers earned cash from work and took their children to work, hence emphasizing the compatibility of work with child care. Work least compatible with child care had a negative effect on breast-feeding intensity in Nigeria. The negative effect of mother's work on exclusive breast-feeding (that is, if the mothers used formula or milk instead) observed for some working mothers in Nigeria and Uganda was partly confounded by urban residence, exposure to media, and other socioeconomic factors. Mother's work did not have a negative effect on breast-feeding intensity in Uganda. The relationship between mother's work, urban residence, media exposure, and breast-feeding practice seems to be stronger in Nigeria than Uganda.
Vehapoglu, Aysel; Yazıcı, Mebrure; Demir, Ayşegul Dogan; Turkmen, Serdar; Nursoy, Mustafa; Ozkaya, Emin
We assessed the association of breast-feeding and timing of solid food introduction with childhood obesity. The children were grouped according to the duration of breast-feeding (0-1, 2-6, 7-12, 13-18, and 19-24 months) and the age at which solid foods were introduced (<4, 4-5, and ≥6 months). In this study, we enrolled 4990 children aged 2-14 years. The rate of exclusive breast-feeding at 6 months of age was 49.1%. We found no association between the duration of breast-feeding and childhood obesity [odds ratio (OR) 0.948, 95% confidence interval (95% CI) 0.694-1.295]. The regression analysis revealed no significant differences in obesity or overweight rates between the early and late introduction to solid food groups (OR 0.993, 95% CI 0.645-1.531). Although breastfeeding has been previously reported to protect against childhood obesity, we were unable to find a significant association between obesity and either longer duration of breastfeeding or later introduction to solid foods in our sample.
Leung, Gabriel M; Lam, Tai Hing; Ho, Lai Ming
To examine the effects of cesarean and forceps or vacuum delivery and parental smoking habits on the initiation and duration of breast-feeding. We conducted a prospective, population-based birth cohort study in 1997. Data were collected on breast-feeding history, household smoking habits, method of delivery, and other demographic, obstetric, behavioral, and potential confounding variables via a standardized self-administered questionnaire. Multivariable logistic regression was used to examine the association between method of birth (cesarean versus forceps or vacuum delivery versus normal vaginal birth) and either not initiating breast-feeding or doing so for less than 1 month. Among women who breast-fed for 1 month or more, multivariable survival analysis was employed to study the relationship between method of delivery and breast-feeding duration. We repeated these analyses to examine the link between parental smoking habits and breast-feeding initiation and duration. A total of 7825 mother-infant pairs were followed up for 9 months. Cesarean delivery was a risk factor for not initiating breast-feeding, for breast-feeding less than 1 month, and remained a significant hazard against breast-feeding duration. Assisted delivery with forceps or vacuum, although not associated with breast-feeding initiation, was a significant risk against breast-feeding duration. Conversely, current parental smoking habits only affected breast-feeding initiation but were unrelated to breast-feeding duration. This study indicates a possible effect of forceps or vacuum delivery on breast-feeding and of cesarean on long-term breast-feeding duration. The findings provide additional evidence in support of the avoidance of unnecessary obstetric interventions.
Dennis, Cindy-Lee; Hodnett, Ellen; Gallop, Ruth; Chalmers, Beverley
Background Most mothers stop breast-feeding before the recommended 6 months post partum. A systematic review showed that breast-feeding support programs by health care professionals did not substantially improve breast-feeding outcomes beyond 2 months post partum. We conducted a randomized controlled trial to evaluate the effect of peer (mother-to-mother) support on breast-feeding duration among first-time breast-feeding mothers. Methods We recruited 256 breast-feeding mothers from 2 semi-urban community hospitals near Toronto and randomly assigned them to a control group (conventional care) or a peer support group (conventional care plus telephone-based support, initiated within 48 hours after hospital discharge, from a woman experienced with breast-feeding who attended a 2.5-hour orientation session). Follow-up of breast-feeding duration, maternal satisfaction with infant feeding method and perceptions of peer support received was conducted at 4, 8 and 12 weeks post partum. Results Significantly more mothers in the peer support group than in the control group continued to breast-feed at 3 months post partum (81.1% v. 66.9%, p = 0.01) and did so exclusively (56.8% v. 40.3%, p = 0.01). Breast-feeding rates at 4, 8 and 12 weeks post partum were 92.4%, 84.8% and 81.1% respectively among the mothers in the peer support group, as compared with 83.9%, 75.0% and 66.9% among those in the control group (p ≤ 0.05 for all time periods). The corresponding relative risks were 1.10 (95% confidence interval [CI] 1.01–2.72) at 4 weeks, 1.13 (95% CI 1.00–1.28) at 8 weeks and 1.21 (95% CI 1.04–1.41) at 12 weeks post partum. In addition, when asked for an overall rating of their feeding experience, significantly fewer mothers in the peer support group than in the control group were dissatisfied (1.5% v. 10.5%) (p = 0.02). Of the 130 mothers who evaluated the peer support intervention, 81.6% were satisfied with their peer volunteer experience and 100% felt that all new breast-feeding
Hauck, Yvonne L; Graham-Smith, Catherine; McInerney, Justine; Kay, Sue
to explore women's perceptions of conflicting advice around breast feeding from formal support networks, specifically health professionals involved in postnatal support. a qualitative exploratory design was employed using the critical incident technique. Data were obtained from 62 Western Australian women who responded to an invitation to share incidents of receiving conflicting advice. Women who had breast fed a child within the past 12 months shared their experience through a telephone interview (n = 50) or completing a brief questionnaire (n = 12) addressing the following questions: Describe a situation in detail where you felt you received conflicting advice about breast feeding from a health professional. How did this situation affect you and/or your breast feeding? a modified constant comparison method was used to analyse the critical incidents revealing commonalities under who offered conflicting advice; what contributed to advice being perceived as conflicting; topic areas more inclined to being regarded as conflicting; what protected against advice being perceived as conflicting; the consequences of receiving conflicting advice; and strategies that women used to manage these incidents. advice that was viewed as conflicting extended beyond the provision of information that was inconsistent or directly contradictory, and included issues around information overload and disparities between the mother's and health professional's expectations. The manner of presenting information or advice, the skills of using effective communication, demonstration of a caring attitude with an empathic approach and focusing upon the woman as an individual were seen to be important to minimise these incidents. Attention to women's perceptions and the consequences of conflicting advice must be addressed, otherwise the credibility and confidence in health professionals' knowledge and ability to support breast feeding is questioned, resulting in a valuable support network being
Grieger, Jessica A; Scott, Jane; Cobiac, Lynne
To determine the dietary patterns of a national sample of 2-8-year-old Australian children and to establish whether breast-feeding is associated with dietary patterns in this age group. Cross-sectional study using 24 h recall data from the 2007 Australian National Children's Nutrition and Physical Activity Survey. Australia. A total of 2287 children aged 2-8 years. Principal component factor analysis identified three distinct patterns. The 'Non-core food groups' pattern included food groups such as whole-fat dairy products, cheese, medium-high sugar-sweetened breakfast cereals and sweet biscuits, no fruit, reduced/low-fat dairy products and wholegrain bread/rolls. The 'Healthy, meat and vegetable' pattern included vegetables, red meat, fruit and wholegrain bread/rolls and was inversely associated with take-away foods and carbonated sugar-sweetened beverages. The 'Combination' pattern contained many food groups including candy (not chocolate based), pasta/rice products, nuts/seeds, cakes and chocolate, but no fruit or vegetables. Of the 2287 children, 2064 (89·3 %) had been breast-fed. A positive association was found between breast-feeding and the healthy, meat and vegetable pattern (r = 0·267) but not with the other two patterns. Higher scores on this pattern were also associated with younger age, lower BMI, higher birth weight, high likelihood of being in the less-disadvantaged Socio-economic Indexes for Areas category and less likelihood of the child's parents having a lower educational level. These results provide suggestive evidence that breast-feeding during infancy is associated with a healthy dietary pattern in childhood and offers a likely pathway to explain the previously reported association between breast-feeding and chronic disease.
Campbell, C E
The breast vs. bottle feeding issue has sparked a controversial debate. Mainstream analysis of the problem shows that arguments made by the business community, as represented by the Nestle Corporation, do not withstand examination of the evidence. For example, it cannot be substantiated that women begin formula feeding because they have entered the labor force. Mainstream studies of cost effectiveness further indicate that bottle feeding is a drain on the incomes of impoverished Third World families and nations. Marxist analysis gives a very different perspective. Nestle represents 19th century capitalist development and the Industrial Revolution, and 20th century imperialism, neocolonialism and monopoly capitalism. Its motive has been capital accumulation and expansion. To increase surplus value appropriation, capitalism must devalue the household (subsistence) economy in which women enjoyed considerable status. Women also produce the most fundamental commodity for capitalism-laborers; therefore, the biological connection must be masked and controlled for the benefit of capital. Thus, as the capitalist mode of production has developed, women have been removed from important roles in production and reproduction. Coupled with the ascendancy of science, expertism and public health imperialism, breast feeding in any market economy becomes nearly impossible. As women internalize the values of capitalist ideology, they elevate "man-made" marketed commodities over subsistence goods such as breast milk.
Hanson, Lars A
The newborn receives, via the placenta, maternal IgG antibodies against the microbes present in its surroundings, but such antibodies have a pro-inflammatory action, initiating the complement system and phagocytes. Although the host defence mechanisms of the neonate that involve inflammatory reactivity are somewhat inefficient, this defence system can still have catabolic effects. Breast-feeding compensates for this relative inefficiency of host defence in the neonate by providing considerable amounts of secretory IgA antibodies directed particularly against the microbial flora of the mother and her environment. These antibodies bind the microbes that are appearing on the infant's mucosal membranes, preventing activation of the pro-inflammatory defence. The major milk protein lactoferrin can destroy microbes and reduce inflammatory responses. The non-absorbed milk oligosaccharides block attachment of microbes to the infant's mucosae, preventing infections. The milk may contain anti-secretory factor, which is anti-inflammatory, preventing mastitis in mothers and diarrhoea in infants. Numerous additional factors in the milk are of unknown function, although IL-7 is linked to the larger size of the thymus and the enhanced development of intestinal Tgammadelta lymphocytes in breast-fed compared with non-breast-fed infants. Several additional components in the milk may help to explain why breast-feeding can reduce infant mortality, protecting against neonatal septicaemia and meningitis. It is therefore important to start breast-feeding immediately. Protection is also apparent against diarrhoea, respiratory infections and otitis media. There may be protection against urinary tract infections and necrotizing enterocolitis, and possibly also against allergy and certain other immunological diseases, and tumours. In conclusion, breast-feeding provides a very broad multifactorial anti-inflammatory defence for the infant.
Schafer, Ellen J; Campo, Shelly; Colaizy, Tarah T; Mulder, Pamela J; Breheny, Patrick; Ashida, Sato
Breast-feeding initiation rates have increased in the USA; however, maintenance of breast-feeding for recommended durations is low. The objective of the present study was to identify factors that may facilitate breast-feeding for longer durations among first-time mothers, including physiological and social experiences and changes in maternal perceptions. Survival analysis and linear regression methods were used to explore the relationship between experiences and breast-feeding duration, and the possible mediating effect of changes in maternal perceptions. Secondary data from the Infant Feeding Practices Study II, conducted in the USA between 2005 and 2007. Data from 762 first-time mothers who ever breast-fed were analysed. Experiencing trouble with baby's latch, problems with milk flow/supply and painful breast-feeding were significantly associated with breast-feeding duration (64, 26 and 36 % shorter duration, respectively). Meanwhile, positive changes in perception with respect to breast-feeding self-efficacy, opinion about infant feeding and belief about breast milk were associated with 16-27 % longer duration. Furthermore, changes in perception were observed to partially mediate the impact of physiological experiences on breast-feeding duration. Perceptions of breast-feeding self-efficacy, beliefs and opinions can change over time and are influenced by breast-feeding experiences. The combined effect of experience and perception plays a key role in influencing breast-feeding duration. Future research should explore interventions to maintain or improve these perceptions while accounting for physiological experiences to support breast-feeding for recommended durations among first-time mothers.
Rempel, Lynn A; Moore, Katrina C J
To evaluate a prenatal breast-feeding class developed and facilitated by peer Breast-feeding Buddies. Non-equivalent control group quasi-experimental study comparing participants of the peer-led class (PLC) to those attending an established hospital-based breast-feeding nurse-led class (NLC). A brief questionnaire was completed immediately prior to the class, and telephone interviews were conducted approximately one week following the class, and one and six months post partum. 54 expectant mothers who registered for the community PLC and 55 expectant mothers who registered for the NLC. Breast-feeding intentions were measured at all time-points. Class evaluations, breast-feedi