Breastfeeding In China Research Articles

Effectiveness of a theory-based breastfeeding promotion intervention on exclusive breastfeeding in China: A randomised controlled trial

ObjectiveTo investigate the effectiveness of a designed intervention programme on the promotion of exclusive breast feeding during 6 months post partum among Chinese primiparous women, based on the theory of planned behaviour. DesignRandomised controlled trial. SettingA tertiary hospital in Shanghai, China. ParticipantsChinese primiparous women who were able to breastfed their babies and companied by either husband or mothers. InterventionParticipants were randomly divided into the intervention and control group. On the basis of the theory of planned behaviour, mothers in the intervention group received the TPB-based intervention programme, including individual instruction, group education and telephone counselling, whereas both the intervention and control group continued to receive routine nursing care. Measurements and FindingsData were collected between October 2013 and June 2014. Initially, 352 participants were included. However, 67 of them dropped out or were lost to follow-up. Finally, 285 participants were included into the analysis, including 157 participants in the intervention group and 128 participants in the control group. Though some bias might exist, rates of exclusive breast feeding were consistently and significantly higher in the intervention group than the control group at 3 days (40.1% versus 10.9%, P<0.001), 6 weeks (57.3% versus 29.7%, P<0.001), 4 months (56.7% versus 15.6%, P<0.001) and 6 months post partum (42.0% versus 10.2%, P<0.001). Conclusion and implicationsThe TPB-based breast-feeding promotion intervention is effective in improving exclusive breast-feeding rates in primiparous women. Although the current intervention that provides continued support during the hospitalisation and follow-up at home, problems remains in the workplaces.

Breastfeeding practices on postnatal wards in urban and rural areas of the Deyang region, Sichuan province of China.

BackgroundDespite the efforts that have been made to promote breastfeeding in China since the 1990s, there is still a very low prevalence of exclusive breastfeeding. The objective of this study was to assess the current situation of infant feeding practices during the postpartum hospital stay in urban and rural areas of the Deyang region.MethodsCross-sectional sampling was used in two urban hospitals and five rural clinics in the Deyang region of southwestern China. Interviews with mothers after delivery (urban n = 102, rural n = 99) were conducted before discharge and five focus group discussions were held.ResultsThe prevalence of Caesarean section was high in both urban and rural areas (63.9 % urban vs. 68.4 % rural). After birth, nearly all mothers (98.0 % urban vs. 99.0 % rural) initiated breastfeeding. One week after delivery, the prevalence of exclusive breastfeeding was 8.0 % (9.8 % urban vs. 6.1 % rural), almost exclusive breastfeeding 34.5 % (29.4 % urban vs. 39.8 % rural), mixed feeding 56.0 % (58.8 % urban vs. 53.1 % rural), and exclusive formula feeding 1.5 % (2.0 % urban vs. 1.0 % rural).Breastfeeding initiation (≤ two days after birth) was positively associated (Odds Ratio [OR] 1.97, 95 % Confidence Interval [CI] 1.11, 3.50) with exclusive and almost exclusive breastfeeding, whereas birth length under 50 cm (OR 0.48, 95 % CI 0.26, 0.87), mother’s education > 12 years (OR 0.46, 95 % CI 0.24, 0.88) and mother’s lack of knowledge about the importance of colostrum (OR 0.35, 95 % CI 0.14, 0.86) were negatively associated with almost exclusive breastfeeding.ConclusionAlthough disparities between urban and rural areas exist, the situation of infant feeding is inadequate in both settings. The high prevalence of Caesarean section, the mothers’ poor knowledge of the physiology of breast milk production, the mothers’ lack of breastfeeding confidence, the widespread advertising of breast milk substitutes, and the changing perception of the function of breasts, may influence the unfavorable breastfeeding behavior observed in the study area.

A survey on difficulties and desires of breast-feeding women in Wuhan, China

Objectivesexclusive 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. Methodsthree 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. Resultsthe 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. Conclusionsto 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.

Effects of a Theory-based Breastfeeding Promotion Intervention on Exclusive Breastfeeding in China

The benefits of exclusive breastfeeding (EBF) are well known; EBF is recommended for the first six months of an infant's life. However, EBF rates remain low and unsatisfactory in China. This study aimed to investigate the effectiveness of a breastfeeding promotion intervention based on the theory of planned behavior (TPB) to promote long-term exclusive breastfeeding rates among first-time Chinese mothers. A longitudinal, randomized, controlled trial was conducted at Shanghai First Maternity and Infant Hospital in Shanghai, China. The participants were 285 first-time Chinese mothers. The intervention group (n=157) was offered a specially designed nursing intervention program based on TPB, whereas the control group (n=128) received routine nursing care. Data of exclusive breastfeeding practices were collected at 3 days, 6 weeks, and 4 and 6 months postpartum. Data pertaining to breastfeeding medi- ating factors were collected three times at the first day after birth, 3 days, and 6 weeks postpartum. A Chi-square test and repeated measures ANOVA were used for the data analysis. The results showed that the intervention group had significantly higher scores than the control group in breastfeeding knowledge, attitude, subjective norm, and perceived control (at least p< 0.01). The rates of exclusive breastfeeding at the different time points of the intervention group (40.1%, 57.3%, 56.7%, and 42.0%) were consistently and significantly higher than those of the control group (10.9%, 29.7%, 15.6%, and 10.2%) (at least p< 0.01). It could be concluded that this theory-based breastfeeding promotion intervention was effective for improving long-term exclusive breastfeeding rates in China.

Predictors of Breastfeeding Exclusivity in Three Cities of China

Breastfeeding MedicineVol. 9, No. 2 Letters to the EditorPredictors of Breastfeeding Exclusivity in Three Cities of ChinaXiu Zhu, Jing Tian, GuiLiu Chen, and Kyllike ChristenssonXiu ZhuPeking University School of Nursing, Beijing, People's Republic of China.Search for more papers by this author, Jing TianThe First Affiliated Hospital with Nanjing Medical University, Nanjing, People's Republic of China.Search for more papers by this author, GuiLiu ChenAn Hui Provincial Hospital, HeFei City, People's Republic of China.Search for more papers by this author, and Kyllike ChristenssonDivision of Reproductive Health, Department of Women's and Children's Health, Karolinska Institute, Stockholm, Sweden.Search for more papers by this authorPublished Online:24 Feb 2014https://doi.org/10.1089/bfm.2013.0053AboutSectionsView articleView Full TextPDF/EPUB Permissions & CitationsPermissionsDownload CitationsTrack CitationsAdd to favorites Back To Publication ShareShare onFacebookTwitterLinked InRedditEmail View article"Predictors of Breastfeeding Exclusivity in Three Cities of China." Breastfeeding Medicine, 9(2), pp. 103–104FiguresReferencesRelatedDetailsCited byMixed milk feeding: a systematic review and meta-analysis of its prevalence and drivers1 May 2020 | Nutrition Reviews, Vol. 78, No. 11Does Caesarean Section Affect Breastfeeding Practices in China? A Systematic Review and Meta-Analysis10 October 2017 | Maternal and Child Health Journal, Vol. 21, No. 11In-Hospital Formula Supplementation of Healthy Newborns: Practices, Reasons, and Their Medical Justification Marija Boban and Irena Zakarija-Grković1 November 2016 | Breastfeeding Medicine, Vol. 11, No. 9Effectiveness of a theory-based breastfeeding promotion intervention on exclusive breastfeeding in China: A randomised controlled trialMidwifery, Vol. 42Predictors of suboptimal breastfeeding: an opportunity for public health interventions4 November 2015 | The European Journal of Public Health, Vol. 26, No. 2 Volume 9Issue 2Mar 2014 InformationCopyright 2014, Mary Ann Liebert, Inc.To cite this article:Xiu Zhu, Jing Tian, GuiLiu Chen, and Kyllike Christensson.Predictors of Breastfeeding Exclusivity in Three Cities of China.Breastfeeding Medicine.Mar 2014.103-104.http://doi.org/10.1089/bfm.2013.0053Published in Volume: 9 Issue 2: February 24, 2014Online Ahead of Print:November 26, 2013PDF download

Breastfeeding rates in central and western China in 2010: implications for child and population health

To describe breastfeeding practices in rural China using globally recommended indicators and to compare them with practices in neighbouring countries and large emerging economies. A community-based, cross-sectional survey of 2354 children younger than 2years in 26 poor, rural counties in 12 central and western provinces was conducted. Associations between indicators of infant and young child feeding and socioeconomic, demographic and health service variables were explored and rates were compared with the most recent data from China and other nations. Overall, 98.3% of infants had been breastfed. However, only 59.4% had initiated breastfeeding early (i.e. within 1hour of birth); only 55.5% and 9.4% had continued breastfeeding for 1and 2years, respectively, and only 28.7% of infants younger than 6months had been exclusively breastfed. Early initiation of breastfeeding was positively associated with at least five antenatal clinic visits (adjusted odds ratio, aOR: 3.48; P < 0.001) and negatively associated with delivery by Caesarean (aOR: 0.53; P < 0.001) or in a referral-level facility (aOR: 0.6; P = 0.014). Exclusive breastfeeding among children younger than 6months was positively associated with delivery in a referral-level facility (aOR: 2.22; P < 0.05). Breastfeeding was not associated with maternal age or education, ethnicity or household wealth. Surveyed rates of exclusive and continued breastfeeding were mostly lower than in other nations. Despite efforts to promote breastfeeding in China, rates are very low. A commitment to improve infant and young child feeding is needed to reduce mortality and morbidity.

Breastfeeding Is a Dynamic Biological Process—Not Simply a Meal at the Breast

Breastfeeding MedicineVol. 6, No. 5 Federal Government: Washington Leadership and ProgressBreastfeeding Is a Dynamic Biological Process—Not Simply a Meal at the BreastTonse N.K. RajuTonse N.K. RajuSearch for more papers by this authorPublished Online:18 Oct 2011https://doi.org/10.1089/bfm.2011.0081AboutSectionsView articleView Full TextPDF/EPUB ToolsPermissionsDownload CitationsTrack CitationsAdd to favorites Back To Publication ShareShare onFacebookTwitterLinked InRedditEmail View articleFiguresReferencesRelatedDetailsCited ByImpact of caesarean delivery on children’s autism-like behaviours: the mediation of exclusive breastfeeding15 July 2022 | International Breastfeeding Journal, Vol. 17, No. 1Human Breast Milk: From Food to Active Immune Response With Disease Protection in Infants and Mothers5 April 2022 | Frontiers in Immunology, Vol. 13Longitudinal Human Milk miRNA Composition over the First 3 mo of Lactation in a Cohort of Healthy Mothers Delivering Term Infants11 September 2021 | The Journal of Nutrition, Vol. 152, No. 1Attachment and Caregiving in the Mother–Infant Dyad: Evolutionary Developmental Psychology Models of their Origins in the Environment of Evolutionary Adaptedness1 January 2022A multi-center longitudinal study on responsive breastfeeding in China from the perspective of health equity: research protocol1 May 2021 | International Journal for Equity in Health, Vol. 20, No. 1The role of vitamin A and its pro-vitamin carotenoids in fetal and neonatal programming: gaps in knowledge and metabolic pathways28 June 2020 | Nutrition Reviews, Vol. 79, No. 1Affectionate Touch in the Context of Breastfeeding and Maternal Depression Influences Infant Neurodevelopmental and Temperamental Substrates18 January 2021 | Neuropsychobiology, Vol. 80, No. 2Why Our Gastrointestinal Tract Is So ImportantClinics in Perinatology, Vol. 47, No. 2Breastfeeding and offspring’s compassion and empathy in adulthood: A study with an over 30‐year follow‐up10 December 2019 | Scandinavian Journal of Psychology, Vol. 61, No. 2“Am I doing this wrong?” Breastfeeding mothers' use of an online forum30 September 2019 | Maternal & Child Nutrition, Vol. 16, No. 1Maternal challenges of exclusive breastfeeding and complementary feeding in Ghana2 May 2019 | PLOS ONE, Vol. 14, No. 5Association Between Breastfeeding Initiation and Duration and Autism Spectrum Disorder in Preschool Children Enrolled in the Study to Explore Early Development9 March 2019 | Autism Research, Vol. 12, No. 5Psychological effects of breastfeeding on children and mothers22 June 2018 | Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz, Vol. 61, No. 8Direct Feeding at the Breast Is Associated with Breast Milk Feeding Duration among Preterm Infants1 November 2017 | Nutrients, Vol. 9, No. 11Evaluation of the impact of breast milk expression in early postpartum period on breastfeeding duration: a prospective cohort study20 October 2015 | BMC Pregnancy and Childbirth, Vol. 15, No. 1Genetic variation in CD38 and breastfeeding experience interact to impact infants’ attention to social eye cues14 September 2015 | Proceedings of the National Academy of Sciences, Vol. 112, No. 39Breastfeeding experience differentially impacts recognition of happiness and anger in mothers12 November 2014 | Scientific Reports, Vol. 4, No. 1Duration of exclusive breastfeeding is associated with differences in infants’ brain responses to emotional body expressions22 January 2015 | Frontiers in Behavioral Neuroscience, Vol. 8Breast feeding and intergenerational social mobility: what are the mechanisms?24 June 2013 | Archives of Disease in Childhood, Vol. 98, No. 9Food in an evolutionary context: insights from mother's milk21 June 2012 | Journal of the Science of Food and Agriculture, Vol. 92, No. 11 Volume 6Issue 5Oct 2011 InformationCopyright 2011, Mary Ann Liebert, Inc.To cite this article:Tonse N.K. Raju.Breastfeeding Is a Dynamic Biological Process—Not Simply a Meal at the Breast.Breastfeeding Medicine.Oct 2011.257-259.http://doi.org/10.1089/bfm.2011.0081Published in Volume: 6 Issue 5: October 18, 2011PDF download

Initiation of breastfeeding and prevalence of exclusive breastfeeding at hospital discharge in urban, suburban and rural areas of Zhejiang China.

BackgroundRates of exclusive breastfeeding in China are relatively low and below national targets. The aim of this study was to document the factors that influence exclusive breastfeeding initiation in Zhejiang, PR China.MethodsA cohort study of infant feeding practices was undertaken in Zhejiang Province, an eastern coastal region of China. A total of 1520 mothers who delivered in four hospitals located in city, suburb and rural areas during late 2004 to 2005 were enrolled in the study. Multivariate logistic regression analysis was used to explore factors related to exclusive breastfeeding initiation.ResultsOn discharge from hospital, 50.3% of the mothers were exclusively breastfeeding their infants out of 96.9% of the mothers who had earlier initiated breastfeeding. Exclusive breastfeeding was positively related to vaginal birth, baby's first feed being breast milk, mother living in the suburbs or rural areas, younger age of mother, lower maternal education level and family income.ConclusionThe exclusive breastfeeding rate in Zhejiang is only 50.3% on discharge and does not reach Chinese or international targets. A number of behaviours have been identified in the study that could be potentially incorporated into health promotion activities.

A decade of change in breastfeeding in China's far north-west.

BackgroundThere have been considerable changes in breastfeeding practices in China over the past forty years. However China is a very large country, and breastfeeding rates in different parts of China vary considerably. The objective of this paper is to identify and compare breastfeeding types and rates between 1994–1996 and 2003–2004 in Shihezi, Xinjiang Uygur Autonomous Region, PR China.MethodsIn 1994–1996, a study of breastfeeding (n = 2197) was undertaken in Shihezi, Xinjiang, PR China. A decade later in 2003–2004, a longitudinal study (n = 545) of infant feeding practices was undertaken in the same area.ResultsThe 'any breastfeeding' rates at 1, 4 and 6 months were 94%, 82% and 78% respectively in the early 1990s. A decade later, breastfeeding at 1 month was lower, but rates at 4 and 6 months remained the same. In 2004 the 'full breastfeeding' rate at one month was significantly higher (57%) than a decade earlier (38%), but after 3 months there was a rapid decline. This reflected a shift in the way complementary foods are introduced: the initial introduction was later, but by a higher proportion of mothers.ConclusionThe rate of breastfeeding at one month is significantly lower in 2003–2004 when compared to 1994–1996. The 'full breastfeeding' rates were initially higher, but after 3 months were then lower. The Chinese national breastfeeding targets were not reached in either period of the study. These studies show the need to further promote full or exclusive breastfeeding and further longitudinal studies are necessary to provide the detailed knowledge about risk factors required for health promotion programs.

Breast feeding among the Chinese in four countries.

This paper examines various aspects of breastfeeding among the Chinese residing in 4 countries: 1) in Sarawak a semiwesternized Malay society; 2) in Singapore a westernized Chinese society; 3) in Peoples Republic of China communist Chinese society and; 4) in Britain. In Sarawak the newly delivered mother and her infant are customarily secluded in the house for 30 days creating an atmosphere ideal for breastfeeding and maternal-child bonding. In spite of this custom however only 67% of urbanized mothers breastfed their babies and of these only 25% and 10% of mothers breastfed their babies for longer than 7 months and 3 months respectively. Incidence of breastfeeding is much higher in the Chinese-educated Chinese (80%) than the English-educated mothers (37.5%) but there is no difference in duration of breastfeeding for the 2 groups. In the Peoples Republic breastfeeding is universally practiced accounting for the virtual elimination of infantile malnutrition. Duration of breastfeeding appears to be declining though (infants are breastfed for 7 or 8 months compared to the customary 12 months; in rural areas babies are breastfed for at least 18 months). Data on breastfeeding in China are scarce and fragmentary. A more detailed study of breastfeeding in China should be useful to other developing countries. In Singapore the decline in the incidence and duration of breastfeeding is more marked among the poor Chinese than among the wealthy Chinese due to urbanization Westernization milk powder commercialization and womens liberation. In 1971 incidence of breastfeeding at birth was 30% for the poor and 50% for the wealthy. A vigorous breastfeeding campaign is currently underway to promote breastfeeding in Singapore. In Britain only 2% of Chinese babies are breastfed and reasons given by mothers are inconvenience insufficient milk and unfashionable. It appears that environment has a marked effect on the practice of breastfeeding.