Bottle Feeding Practices Research Articles

Using intervention mapping to develop a culturally appropriate intervention to prevent childhood obesity: the HAPPY (Healthy and Active Parenting Programme for Early Years) study

IntroductionInterventions that make extensive use of theory tend to have larger effects on behaviour. The Intervention Mapping (IM) framework incorporates theory into intervention design, implementation and evaluation, and was applied to the development of a community-based childhood obesity prevention intervention for a multi-ethnic population.MethodsIM was applied as follows: 1) Needs assessment of the community and culture; consideration of evidence-base, policy and practice; 2) Identification of desired outcomes and change objectives following identification of barriers to behaviour change mapped alongside psychological determinants (e.g. knowledge, self-efficacy, intention); 3) Selection of theory-based methods and practical applications to address barriers to behaviour change (e.g., strategies for responsive feeding); 4) Design of the intervention by developing evidence-based interactive activities and resources (e.g., visual aids to show babies stomach size). The activities were integrated into an existing parenting programme; 5) Adoption and implementation: parenting practitioners were trained by healthcare professionals to deliver the programme within Children Centres.ResultsHAPPY (Healthy and Active Parenting Programme for Early Years) is aimed at overweight and obese pregnant women (BMI > 25); consists of 12 × 2.5 hr. sessions (6 ante-natal from 24 weeks; 6 postnatal up to 9 months); it addresses mother’s diet and physical activity, breast or bottle feeding, infant diet and parental feeding practices, and infant physical activity.ConclusionWe have demonstrated that IM is a feasible and helpful method for providing an evidence based and theoretical structure to a complex health behaviour change intervention. The next stage will be to assess the impact of the intervention on behaviour change and clinical factors associated with childhood obesity. The HAPPY programme is currently being tested as part of a randomised controlled feasibility trial.

Prevalence of early childhood caries and associated risk factors in preschool children of urban Bangalore, India: A cross-sectional study

Early childhood caries (ECC) is a devastating form of dental decay with multi-factorial origin. The aim of this cross-sectional study is to investigate the prevalence and related risk factors of ECC in preschool children of urban Bangalore (India). A random sample of 1,500 children aged between 8 and 48 months were selected from various parts of urban Bangalore. The status of dental caries was recorded according to the World Health Organization (WHO) criteria. Information regarding oral hygiene practices, feeding habits, socio-economic status, birth weight, and educational status of the mother was obtained through a structured questionnaire given to mothers of preschool children. The data was subjected to statistical analysis using the Statistical package for social sciences (SPSS) version 12. The prevalence of ECC in preschool children was 27.5%, while the mean deft was 0.854. ECC increased significantly with age. Children whose mothers had no schooling and those who belonged to low socioeconomic group showed higher caries prevalence. A significant increase in caries prevalence was found in children accustomed to the practice of on-demand breast feeding and bottle feeding at night. Caries also increased significantly when snacks were consumed between meals. However, increased frequency of tooth-brushing, parental supervision, use of a baby toothbrush, and fluoridated dentifrice significantly decreased caries prevalence. ECC is a serious public health problem in this population and measures to increase awareness should be undertaken. The target candidates for oral health promotion programs should include mothers, general dentists, pediatricians, nurses, primary care health workers, care-takers at day-care centers and gynecologists.

Madres y enfermeras: el modelo de cuidados a la infancia en la colección «Al servicio de España y del niño español» (1938-1964)

Objetivos: El estudio se plantea profundizar en el análisis del discurso del régimen franquista que se dirigió a la población femenina, especialmente a las madres y a las enfermeras, en relación con los cuidados a la infancia. Métodos: Se analizó la colección «Al Servicio de España y del Niño Español» (1938-1964), publicada por el Ministerio de Gobernación, mediante un análisis del contenido de las monografías que se ocupaban del los cuidados a la infancia. Discusión y conclusiones: El régimen franquista condenó el trabajo fuera del hogar de las mujeres y promovió una política pronatalista. Las mujeres fueron consideradas ignorantes y por tanto culpables de la elevada mortalidad infantil. Su acción se orientó a capacitar a todas las mujeres (que algún día llegarían a ser madres) en el cuidado de los niños. Fue obligatoria la enseñanza de la puericultura a las niñas en todos los niveles. Se fomento la lactancia materna con un discurso culpabilizador (la mujer que no lacta es una semimadre). Con todo, a pesar de todas estas iniciativas pronatalistas, la realidad social se impuso y la natalidad disminuyó, y también lo hizo la mortalidad infantil debido a la mejora de las condiciones de vida, al mismo tiempo que se produjo un fuerte aumento del uso del biberón y del trabajo femenino fuera del hogar.

Fathers and breast feeding very-low-birthweight preterm babies

Objective to explore fathers’ experiences of the breast feeding of their very-low-birthweight preterm babies from birth to 12 months of age. Design a qualitative study using interpretive phenomenology. Data were collected via longitudinal in-depth individual interviews. Setting publicly funded tertiary level hospital, Australia. Participants a purposive sample of 17 Australian parents took part in the broader study. This paper reports on data from the seven participant fathers. Findings this paper explores the discursive changes in fathers’ accounts of their perspectives on and support of the breast feeding of their preterm baby. The fathers’ accounts highlight their marked influence on breast feeding, their ambivalent experiences related to breast feeding and their struggle in negotiating a parenting role related to baby feeding. Key conclusions this study highlights the role and influence that fathers of preterm babies have on breast feeding, and explores the tensions and paradoxes inherent in promoting the ideology of breast feeding while valuing the practice of bottle feeding. Implications for practice this study highlights the need to encourage and involve fathers in breast-feeding education including the impact of bottle feeding on breast-feeding outcomes. The active and positive contribution that fathers make towards preterm breast feeding should be acknowledged and encouraged.

Prolonged bottle use and its association with iron deficiency anemia and overweight: a preliminary study.

To determine the prevalence of prolonged bottle feeding practices in young children, and its association with body mass index (BMI) and iron deficiency anemia (IDA), we conducted a cross-sectional survey study at 3 Bronx, NY, WIC sites. Caregivers of 95 predominantly Hispanic and African-American WIC-enrolled children aged 18-56 months presenting for recertification completed questionnaires. Half were overweight (>85th% BMI) and 36% were obese (>95th% BMI); 21% met CDC criteria for anemia. Two thirds (63%) received daily bottles of milk or sweet liquids. Daily bottle use ranged from 3 to 10 (mean=3.3, median=3). Bottle use was significantly associated with obesity (>95th% BMI, p<0.0005), not significant with overweight (>85th% BMI, p<0.06) and statistically significant with IDA.

Caries prevalence and bottle-feeding practices in 2-year-old children with cleft lip, cleft palate, or both in Taiwan.

The purposes of this study were to investigate the caries prevalence in cleft lip, cleft palate, or both in children under the age of 2 years and to evaluate parental attitudes toward bottle-feeding, dental care, and their relationship to baby bottle tooth decay (BBTD) in Taiwan. Randomized and prospective study. Institutional setting. One hundred twenty-three 2-year-old children (68 boys and 55 girls) with cleft lip, cleft palate, or both were selected for this study. A questionnaire that asked questions about knowledge of oral health, knowledge and beliefs about BBTD, children's feeding habits, children's dental care, and parenting attitudes toward children with clefts was completed by the parents or caretakers. Children were divided into bottle-feeding and non-bottle-feeding groups according to the questionnaire responses of parents or caretakers. Each child was examined with a dental mirror and explorer under focused flashlight using defs index to determine the presence of BBTD. Thirty-nine percent (48) subjects reported a bottle-feeding habit; the overall prevalence of BBTD was 15.4%. The habit of bottle-feeding was significantly related to BBTD (p = .019). The defs score for children who were bottle-fed was significantly higher than children who were not bottle-fed (p = .045). Parents or caretakers of both bottle-feeding and non-bottle-feeding children showed no significant differences in their attitudes toward bottle-feeding and feeding habits (p > .05). However, parents of non-bottle-fed children had significantly better dental care than parents of bottle-fed children in brushing frequency (p < .001) and brushing before bed (p < .001). Children with clefts who took a bottle to bed showed an increased risk of developing BBTD. The parents or caretakers of bottle-fed children also showed a lack of motivation to perform regular preventive dental home care for their children. This suggests that oral health promotion programs should begin in infancy for children with clefts and their parents.

Caries Prevalence and Bottle-Feeding Practices in 2-Year-Old Children with Cleft Lip, Cleft Palate, or Both in Taiwan

Caries Prevalence and Bottle-Feeding Practices in 2-Year-Old Children with Cleft Lip, Cleft Palate, or Both in Taiwan

Current status of breast-feeding in Alexandria governorate: a community-based study

Thistudy was carried out to provide baseline data for various indicators measuring breast-feeding and bottle-feeding practices in Alexandria. In 1995, a total of 1080 children aged below 24 months, equally distributed among six age groups, were selected for a household 24-hour dietary survey. The findings indicated that only 42.2% of infants below 4 months were currently exclusively breast-fed, while 21.1% were predominantly breast-fed. Hence, the rate of breast-feeding was 63.3%. The prevalence rate of timely complementary feeding was 62.3%. Continued breast-feeding rate at 1 year was 64.4%, and at 2 years was 33.9%. The bottle-feeding rate [among infants less than 12 months] was 44.3%

Breast and bottle feeding in rural and urban South African children

We studied breast and bottle feeding in 1264 children aged 1–4 years from five South African communities using a questionnaire on feeding habits completed by trained interviewers. The proportion of infants breast feeding ranged from 73% to 94% for mean periods of 9–16 months. The group with the most consistent and prolonged breast feeding habits were rural black children. Different bottle feeding practices were used within the various communities. At the ages studied the types of infant feeding practice varied little within the groups although each group differed significantly from the others for the preferred feeding method.

Breastfeeding patterns in the Arabian Gulf countries.

The rapid economic change experienced in the Arab Gulf countries in the past two decades has resulted in a dramatic decline in the number of infants breast fed and the duration of breast feeding. This survey describes the current status of breast feeding in the Arabian Gulf countries in terms of the duration of exclusive breast feeding; initiation, frequency, and duration of breast feeding; bottle feeding practices; breast feeding and fertility; reasons for cessation of breast feeding; and the relationship between breast feeding and gastroenteritis. After a brief discussion of weaning practices, the paper considers factors influencing the decision to breast feed, including mothers age, education, urban-rural residence, and employment status; the influence of house maids and health workers; and the sex of the child. The marketing of baby foods in the area is described, as are various programs to support breast feeding, such as maternity protection, educational activities, marketing activities, support of appropriate weaning practices, workshops and seminars, and research activities. It is concluded that these programs have had very little effect on the promotion of breast feeding in the region for the following reasons: 1) lack of coordination; 2) lack of health regulations covering formulas and baby foods; 3) the encouragement of bottle feeding in private hospitals; 4) insufficient knowledge of managing breast feeding among health personnel; 5) a shortage of studies relating to breast feeding; and 6) insufficient training of health personnel. The institution of a global promotional policy is recommended. Such a policy would include the development of strict regulations covering marketing of substitutes, training of health workers, mass media campaigns, school and university curricula changes, and convincing policy-makers that breast feeding is beneficial.

NURSHING BOTTLE WEANING: MATERNAL PERSPECTIVES

Numerous studies have documented the deleterious effects of prolonged bottle feeding in children. Little information exists regarding the optimal age for terminating bottle feedings, what advice pediatricians provide to parents, and what methods parents employ for bottle weaning. Information about bottle weaning practices was gathered from 172 mothers with bottle-fed children between the ages of 2 and 5 years (x = 42 mos.) scheduled for pediatric clinic visits. SES ranged from lower to upper middle, with 75% falling in the lower middle and lower categories. Forty percent of mothers reported pediatricians as the primary care provider. Although the mean recommended age for weaning was 7 months, the average age for attainment of daytime bottle weaning was 14 months. Seventy-one percent of mothers reported that bedtime bottle feeding practices were not discussed by their physicians. Forty-five percent of children were allowed to sleep with the bottle, which contained milk in 27% of the cases. Two weaning methods were commonly reported: (1) gradual reduction of the number of bottles (42%) and (2) abrupt termination (38%). Only 11% of mothers cited physicians as the primary source of information on nursing bottle weaning, with 36% relying on instinctual judgement. Data suggest pediatricians need to include explicit information on the timing of and methods for cessation of bottle feeding as part of anticipatory guidance interventions.

The influence of health education on breast feedingpractices in Benin City, Nigeria

Many mothers from developing countries including Nigeria are introducing their babies to artificial milk feeding early in life. This is probably due to the rapidly increasing female education whereby working mothers had to go back to work 6–8 weeks after delivery. In this study, only 31·4% of the mothers wholly breast fed their babies at confinement in spite of the health educational activities of breast feeding practices during antenatal clinic (A.N.C.) attendances. Breast feeding declined rapidly after discharge from hospital, and artificial milk feeding was well established at 6–8 weeks, post confinement, for socio—economic reasons. It is suggested that for these working mothers, bottle-feeding practices should be welldemonstrated to them so as to minimize the ill effects that ignorance and malutilization of the artificial milk may cause. For the non-working mothers, health educational activities on the advantages of breast feeding and breast milk should be continuous and continuing.

How much breast milk do babies need?

A reassessment of the breast milk requirements of young babies at different ages has been made from a statistical analysis of energy intake data collected prospectively in Cambridge, U.K. and from data derived from a literature survey of cross-sectional food energy intakes of infants from Canada, Sweden, the U.K. and USA. In contrast to the slow progressive linear decline in energy requirements per kg body-weight that has previously been assumed, measured intakes have been shown to fall more rapidly in the first six months of life. Thereafter they then rise again as the baby becomes more active. These findings are of fundamental importance to a realistic assessment of the adequacy of breast milk as the sole source of food in the first six months of life. The data show that typical breast milk intakes found in the industrialized countries can satisfy infant energy needs for healthy growth for much longer than would be indicated by current international dietary recommendations. A discussion of the physiological interpretation of the results is included as is an appraisal of their practical significance both to breast and bottle feeding practices.

Infant feeding in national and international perspective: an examination of the decline in human lactation, and the modern crisis in infant and young child feeding practices.

The practice of breast feeding has declined sharply throughout the world in recent years with great economic and health costs associated with this trend. Today most of North America Western Europe and Australia fall into the group of countries where bottle feeding predominates. Most of Asia including India and China and most of black and brown Africa still breast feed. In many urban areas in Asia and Africa and much of Central and South America and Eastern Europe breast feeding is being replaced with bottle feeding. There is poor correlation between levels of industrialization or of female employment and the rates of bottle feeding. In the countries where breast feeding still prevails government policy has encouraged it and given support to motherhood. Developing countries where there is concern that breast feeding will give way to the less healthy and uneconomical practice of bottle feeding the governments could take steps to ensure that the infants of working mothers retain the right to be breast fed insist that the medical profession give support to breast feeding and control the availability of breast milk substitutes. Among other problems with commercial breast milk substitutes the cost is so great that families cannot afford sufficient supplies and thus malnourish their infants. Improved health care programs could help.

Feeding practices in late infancy in Benin City, Edo State, Nigeria

Background: Whereas considerable insight has been gained and progress made in optimum feeding in early infant feeding same cannot be said with nutrition in late infancy. Tacking challenges associated with nutrition in late infancy demands that extant practices and their shortcomings are exposed.Objectives: To evaluate and document practices regarding feeding in late infancy in Benin City, Edo State, Nigeria.Methods: Using a communitybased household survey involving three representative political wards in Egor Local Government Area of Benin City, feeding practices in late infancy were evaluated using a mix of structured and non-structured, pre-tested questionnaires on 522 mothers of infants aged &gt;6months to 11 months. This was done between June and September, 2009.Results: The age range of mothers was 17-48 years. Diverse ethnic groups were represented with the Binis constituting the largest (48.6%). Bottle feeding rate (BOTFR) was 2.55% and Bottle feeding practice was unassociated with maternal occupation (χ2 = 2.741; p=0.740) and family socioeconomic status (χ2=10.145; p=0.930). Timely complimentary feeding rate (TCFR) was very high (92.7%). Delayed introduction of complimentary feeding was very low (3.6%). Maize gruel (pap) was the commonest (76.6%) complementary food utilized and commonly (99.5%) this was enriched with a variety of other items with milk as the commonest item used. Fish was the commonest (41.0%) animal product used as complimentary food. Use of animal feeds was however generally low and their use was uninfluenced by family socio-economic status (χ2 = 5.424, p=0.066).Conclusions/Recommendations: Bottle feeding rate remains unacceptably high even into late infancy. Factors fostering this should be exposed and tackled because of the dangers inherent in the practice. Timely complimentary feeding practice is encouraging and needs to be supported and sustained for its benefits.Key Words: Nutrition, Late, Infancy, Complimentary feeding, Benin City.