Cessation Of Exclusive Breastfeeding Research Articles

Breastfeeding practices and social norms in Kinshasa, Democratic Republic of the Congo: A qualitative study.

Breastfeeding has many benefits for both mothers and children. The World Health Organization recommends exclusive breastfeeding for the first six months of life. However, in the Democratic Republic of the Congo, slightly under half of children under six months are exclusively breastfed. This study aimed to describe breastfeeding practices and to explore perceived social norms regarding breastfeeding among mothers in Kinshasa. A qualitative descriptive study was conducted in Kinshasa from June to July 2013. This study purposively sampled 54 mothers of infants aged 6 to 12 months, who participated in six focus group discussions. Based on the Theory of Planned Behaviour, the discussion guide explored infant feeding in the first six months, knowledge of breastfeeding, perception of the feasibility of exclusive breastfeeding, and perception of the social norms with regard to exclusive breastfeeding. The content analysis approach was used to analyse data. Mothers had good breastfeeding knowledge; however, few of them had practised exclusive breastfeeding as recommended during the first six months. Exclusive breastfeeding was considered unfeasible in their context. Barriers to exclusive breastfeeding were reported as baby's cries, social pressure, warm climate, and poor maternal diet. Social norms were supportive of breastfeeding but unfavourable to exclusive breastfeeding. In Kinshasa, mothers have a good knowledge of breastfeeding. However, few practise exclusive breastfeeding. Social pressure plays an important role in the cessation of exclusive breastfeeding before six months. In order to improve the practice of exclusive breastfeeding in this context, social and behaviour change programmes should target the entire population rather than mothers only.

Infant feeding practices in three Latin American countries in three decades: what demographic, health, and economic factors are relevant?

Studies in Latin America have focused either on analyzing factors associated with exclusive breastfeeding (EBF) or infant formula (IF). Analyze the association between economic, sociodemographic, and health factors with EBF, mixed milk feeding (MixMF), and exclusive use of IF in three Latin American and Caribbean countries in the 1990s, 2000s, and 2010s. Cross-sectional time-series study using data from Demographic and Health Surveys between the 1990s and 2010s in Colombia (1995-2010), Haiti (1994-2017), and Peru (1996-2012) accounting for a sample of 12,775 infants under 6 months. Hierarchical logistic multilevel regression models were used to estimate the adjusted association between infant feeding outcomes (EBF, MixMF, exclusive use of IF) and contextual level DHS survey decade (1990s, 2000s and 2010s) and economic factors (Gross Domestic Product by purchasing power parity, female wage and salaried workers, labor force participation rate female) as well as individual level sociodemographic (maternal age, maternal education, number of children in the household, wealth index, mother living with a partner, area of residence, mother working outside of home), and health factors (breastfed in the first hour, C-section). Factors associated with EBF cessation were c-section (OR: 0.76; 95%CI: 0.64, 0.92), mothers working outside of the home (OR: 0.79; 95%CI: 0.69, 0.90), families in the highest income quintile (OR: 0.64; 95%CI: 0.49, 0.84), and female wage and salaried workers (OR: 0.92; 95%CI: 0.91, 0.94). MixMF was associated with women with higher education (OR: 1.54; 95%CI: 1.21, 1.97), mother working outside of the home (OR: 1.26; 95%CI: 1.10, 1.43), c-section (OR: 1.37; 95%CI: 1.15, 1.62), families in the highest income quintiles (OR: 2.77; 2.10, 3.65). and female wage and salaried workers (OR: 1.08;95% CI: 1.05, 1.09). Exclusive use of IF was associated with a mother working outside of the home (OR: 2.09; 95%CI: 1.41, 3.08), c-section (OR: 1.65; 95%CI: 1.09, 2.51), families in the highest income quintiles (OR: 12.08; 95% CI: 4.26, 34.28), the 2010s (OR: 3.81; 95%CI: 1.86, 7.79), and female wage and salaried workers (OR: 1.12; 95%CI: 1.07, 1.16). Factors related to women empowerment and gender equality jeopardized EBF and favored the exclusive use of IF in Latin America. Therefore, workplace interventions to promote, protect, and support breastfeeding practices are key to reducing exclusive use of IF.

Cessation of exclusive breastfeeding and predictors among infants aged 0-6 months in Ararso district of the Somali region, Ethiopia. A community-based cross-sectional study.

Exclusive breastfeeding (EBF) is the gold standard of child feeding practice in which the infant only receives breast milk without any additional food or drink, not even water and it lasts up to 6 months after delivery. In the study area, there is a lack of data on the prevalence of cessation of EBF. Community-based cross-sectional study design was used among 292 mothers of infants aged 0-6 months. The data was collected using a pretested structured questionnaire. Bivariate and multivariate logistic regression analyses were carried out. An odds ratio with a 95% confidence interval was used to measure the strength of the association. Statistical significance was declared at P-value <0.05. The prevalence of cessation of EBF was 57.3% with 95% CI [50.9-62.6]. This study showed being employed (working outside the home) (AOR = 2.44; 95% CI [1.32-4.53]), being rural residence (AOR = 1.87; 95% CI [1.05-3.32]), and inadequate knowledge of EBF (AOR = 2:02; 95% CI [1.19-3.43]) were independent predictors of cessation of EBF. Our data identified a higher prevalence of cessation of EBF in the study area compared to most studies in Ethiopia and elsewhere. Efforts on improving knowledge of the importance of EBF particularly in rural areas and support for breastfeeding-employed women are recommended.

Factors associated with exclusive breastfeeding of children under six months of age in Cote d’Ivoire

BackgroundDespite benefits of exclusive breastfeeding (EBF) and its strategic place in the national guidelines for infant and young child feeding, its practice remains insufficient in Cote d’Ivoire. It is therefore important to identify its early stopping associated factors. We aimed to (i) assess the extent of children’s exposure to exclusive breastfeeding and the associated explanatory factors for discontinuation before six months, and (ii) to profile non-exclusively breastfed children and interrelationships between these factors.MethodsA secondary analysis of data from the 2016 Cote d’Ivoire Fifth Multi Indicator Cluster Survey (MICS5) of 980 children under six months of age was conducted in this study. Data were analyzed using the actuarial method of survival hazard estimation combined with the Wilcoxon (Gehan) test, discrete time proportional hazards regression models, and Multiple Correspondence Analysis (MCA) to profile the children.ResultsMaternal exposure to counseling session, age at delivery, and child sex were significantly associated with the likelihood of discontinuing exclusive breastfeeding before the first six months of life. Children deprived of EBF resided in urban areas, in high and very high economic welfare households. Their mothers had a secondary education or higher and had three or fewer children.Logistic analysis showed that health status and sex of the child were significantly associated (P < 0.001) with exclusive breastfeeding. An extremely important and rarely studied factor is that children who were sick in weeks prior to the survey were more likely to remain exclusive breastfeeding (adjusted OR 1.80; 95% Confidence Interval (CI) 1.452, 2.234). Girls are less likely to be exclusively breastfed than boys (adjusted OR 1.48; 95% CI 1.22, 1.798). Low standard of living was associated with early cessation of EBF (adjusted OR 2.15; CI 1.325, 3.499). The duration of the exclusive breastfeeding was significantly longer among mothers with high exposure to medical discourse (adjusted OR 0.74; CI 0.595, 0.91).ConclusionsImproving the practice of exclusive breastfeeding in Cote d’Ivoire requires strengthening the capacities of health professionals in terms of advice and assistance to mothers for the practice of exclusive breastfeeding and its maintenance until six months of age, regardless of the health status and sex of the child.

Challenges of Continuation of Exclusive Breast Feeding up to 6 Months in a Setting with High Exclusive Breast Feeding Rates Reported. Experience from Eastern Province of Sri Lanka.

According to the World Breastfeeding Trends Initiative, Sri Lanka ranked as number one and only country to achieve green status. Exclusive breastfeeding (EBF) for six months is current practice with a rate of 75.5% among 0-5months. Identify factors contributing early cessation of breastfeeding in a single centre of Eastern province Sri Lanka. A descriptive cross-sectional study conducted in Sammanthurai Medical officer of Health area. Consecutive mother-infant days with the infant ageing < 6months were included from 25 public health midwife areas using an interviewer administered questionnaire. Missing values imputed using 'missForest' algorithm. The mean age of the sample was 28.4(SD ± 5.6). Of the 257 mothers recruited, 15(5.8%) were teenagers and 42(16.3%) > 35years. 251(97.6%) had children 1-5 and 86(33.5%) were first born. 140 (54.5%) had tertiary education, 28 (10.9%).31(12.1%) were employed. EBF rates 0-6months was 79.8% (n = 205). 239(93.0%) started breastfeeding within an hour. EBF was not associated with maternal age, birth order or income. 18 employed mothers and 186 unemployed mothers continued EBF. Regarding the factors associated with EBF, having a tertiary education (p < .001), being employed (p = .004) and having less than 3 children (p = .03) were associated with non-exclusive breastfeeding. Tertiary education was the significant predictor of non-exclusive breastfeeding in this population with an odds ratio of 4.50 (95% CI 1.331-15.215). Employment identified as a risk factor for early cessation of EBF needs well planned further research to overcome this practical issue. Also might need revision of workplace policies, establishment of lactation areas in office premises to overcome some of these issues.

Does infant sensory responsiveness explain exclusive breastfeeding 6 months after birth?-a cohort prospective study.

Although exclusive breastfeeding (EBF) is recommended for the first 6 months of life, breastfeeding rates in most developed countries are low. Sensory over-responsivity (SOR) has been found to interfere with infant and childcare, development, and routines, but has not yet been examined as a breastfeeding barrier. The aim of this study was to explore the association between infant sensory responsiveness and EBF and whether it can predict EBF cessation prior to 6 months of age. In this cohort prospective study participants were 164 mothers and their infants recruited 2 days after birth in a maternity ward between June 2019 and August 2020. At this time, participating mothers completed a demographic and delivery information questionnaire. At 6 weeks after birth, the mothers completed the Infant Sensory Profile 2 (ISP2), reporting their infants' sensory responsiveness in daily activities. At 6 months, infants' sensory responsiveness was assessed using the Test of Sensory Functions in Infants (TSFI) and the Bayley Scales of Infant and Toddler Development-3rd Edition (Bayley-III) was administered. Additionally, mothers provided information about their breastfeeding status and were divided into two groups accordingly: EBF and non-EBF (NEBF). The incidence of atypical sensory responsiveness (mostly of the SOR type) at 6 weeks was twice as high among NEBF infants than EBF infants (36.2% vs. 17%, χ2=7.41, P=0.006). Significant group differences were found in the ISP2 touch section (F=10.22, P=0.002). In addition, NEBF infants displayed more SOR behaviors than EBF infants in the TSFI deep touch (F=2.916, P=0.001) and tactile integration subtests (F=3.095, P<0.001), and had lower scores in the adaptive motor functions subtest (F=2.443, P=0.013). Logistic regression modeling revealed that ISP2 at 6 weeks (typical vs. atypical) and TSFI total score at 6 months predicted 28% of NEBF at 6 months (χ2=23.072, P=0.010). Infant atypical sensory responsiveness, predominantly of the SOR type, was found to predict NEBF at 6 months after birth. This study contributes to the understanding of EBF barriers, highlighting the importance of early identification of SOR in infants. Findings may suggest developing early sensory interventions and providing individualized breastfeeding support tailored to the infant's unique sensory profile.

The median time to stopover exclusive breastfeeding among employed and unemployed mothers of infants aged 6–12 months in Ethiopia, 2019

Early discontinuation of breastfeeding is known to be associated with avoidable childhood morbidity and mortality. The effect of maternal employment on the duration of exclusive breastfeeding and its determinants has not been addressed adequately in in Ethiopia in general and in the stud area in particular. Hence, this study was aimed to compare the time to stop exclusive breastfeeding and its determinants among employed and unemployed mothers of infants 6–12 months of age. A community-based comparative cross-sectional study was conducted from March 1 to 30, 2019. A total of 426 mothers were recruited using a simple random sampling technique. The Kaplan–Meier curve with log-rank test was used to compare the difference in cessation of exclusive breastfeeding before 6 months. Bivariate and Cox proportional hazards model were computed. Hazard ratios and their 95% confidence intervals were computed to determine the level of significance. Four hundred twenty-six (213 employed and 213 un-employed) mothers were included in the final analysis. The median duration of exclusive breastfeeding was 4 months and 6 months for infants of employed and unemployed mothers, respectively. The likelihood of ceasing of exclusive breastfeeding before 6 months of age was significantly associated with family support of exclusive breastfeeding [AHR = 3.99, 95% CI (1.9, 8.3)], and lack of exclusive breastfeeding counseling during postnatal care [AHR = 7.76, 95% CI (2.99, 20.1)], primipara mothers [AHR = 1.5, 95% CI (1.14, 2.04)], maternity leave of 4 months [AHR = 7, 95% CI 2.2, 22.2)] and employed mothers [AHR = 3.77, 95% CI (2.4, 5.9)]. The median duration of exclusive breastfeeding was shorter among employed mothers than un-employed mothers. It is clear from this study that cessation of exclusive breastfeeding was associated with the duration of paid maternity leave for employed mothers. Family support and perceived adequacy of breast milk were associated with cessation of exclusive breastfeeding before 6 months among unemployed mothers.

Beliefs and Norms Influencing Initiation and Sustenance of Exclusive Breastfeeding: Experiences of Mothers in Primary Health Care Facilities in Ermelo, South Africa.

Exclusive breastfeeding (EBF) is not a norm in many communities in South Africa despite the World Health Organizations' recommendations for EBF in the first six months of infant's life. Thus, South Africa continues to observe suboptimal and poor practices of EBF. The purpose of the study was to explore the experiences of mothers who are HIV-positive and negative on EBF and examine the extent to which initiation and sustenance of EBF is influenced by cultural beliefs, societal norms, and family norms and practices in Mpumalanga Province. Three focus group discussions and twelve in-depth interviews were conducted among thirty mothers who were purposively selected during their visits to the facilities for childcare services. Interviews were audiotaped, transcribed verbatim, and transcripts were analysed through thematic analysis using NVivo version 10. Mothers were aged between 18 and 42 years, most were unemployed and were living in poor sociodemographic backgrounds in extended family households. We found evidence of factors that influence the decision to EBF and mix feed infants among mothers. Traditional and cultural beliefs and norms that exist within their communities informed decisions mothers took to EBF. These beliefs existed alongside mothers' opinions on breastfeeding (BF) and HIV infection, as well as the fears of harming the baby through HIV infection, leading to early cessation of BF. Mothers were also advised by family members, friends, and even some healthcare workers to use traditional medicines while BF. The association of EBF with sagging breasts and weight loss as well as discomfort with public BF are personal beliefs that influenced initiation and early cessation of EBF. Breastfeeding messages ought to be context specific to improve the knowledge, understanding, acceptance and practice of EBF among HIV-positive and negative mothers. Culturally appropriate counselling messages that address the known cultural practices of the populations affected are essential to changing the beliefs and norms of the communities including extended families of EBF mothers.

Predictors of cessation of exclusive breastfeeding according to the Cox regression model: survey of mothers of children aged 6-12 months, Thiès, Senegal.

even though exclusive breastfeeding (EBF) for up to six months is recognised as essential infant care, it is still insufficiently practiced. The objective of this study was to identify predictors of EBF cessation in Thiès. this was a survival analysis of data collected using a cross-sectional procedure. Data collection took place from 2nd December 2019 to 21st January 2020. The study population consisted of mothers of children aged 6 to 12 months residing in Thiès and seen at the reference health centre of the Thiès Health District during infant vaccination sessions. The number of subjects was 400 mothers recruited using a systematic survey, with a sampling interval equal to two. Data were collected through a face-to-face interview. Predictive factors were identified using the Cox regression model. The adjusted hazard ratio (AHR) and its 95% confidence interval (95% CI) are calculated. the average age of the mothers was 27.08 ± 6.34 years. The proportion of mothers who breastfed their child within one hour of birth was 29.25%. The proportion of those who practiced EBF was 41.50%. The incidence density of EBF cessation was 14 person-months per 100 breastfeeding mothers. The median duration of EBF was 5 months. Lack of advice on EBF during antenatal care (AHR=1.42; 95% CI =1.08-1.85), sources of information other than health professionals (AHR =1.51; 95% CI =1.05-2.19), late initiation of EBF, i.e. breastfeeding beyond 24 hours after birth (AHR =1.53; 95% CI =1.02-2.28) and low level of knowledge about EBF (AHR =1.46; 95% CI =1.11-1.92) were significantly associated with early termination of EBF. the promotion of EBF for up to six months will necessarily involve the promotion of prenatal consultations during which professionals should raise awareness among future mothers.

Time to early cessation of exclusive breast feeding and associated factors among 6-12 months old children: Survival analysis.

WHO and UNICEF (1990) have recommended EBF for six months, followed by an introduction of complementary foods at the age of six months with continued breastfeeding for the first 24 months or more. Exclusive breastfeeding (EBF) during the first 6 months of life reduces infant morbidity and mortality. According to Ethiopia Demographic Health Survey (DHS), only 58% of children were exclusively breastfed during the first 6 months of age. The study aimed to identify time to early cessation of EBF and associated factors among 6-12 months old children in Lanfuro Woreda, Silte Zone. A community-based cross-sectional study was conducted in Lanfuro Woreda, Silte Zone, from March to April 2017. A total of 636 mothers with 6-12 months old infants from ten randomly selected kebeles were included. Both quantitative and subjective information assortment techniques were utilized. The Kaplan-Meier curve with log-rank test was used to compare the survival difference by the selected covariates. Both bivariate (P<0.25) and multivariable (P<0.05) Cox Proportional Hazards model were fitted to identify factors predicting time to early cessation of EBF. The median duration of exclusive breastfeeding was 6.22 months. The highest proportion of cessation of exclusive breastfeeding occurred during the first four to five months. Early cessation of exclusive breastfeeding was observed in 295 (48%). Place of residence (AHR: 1.6; 95% CI=1.14-2.20), knowledge on EBF (AHR=1.31; 95% CI=1.02-1.68), type of delivery (AHR: 2.41; 95% CI=2.24-3.68), pre-lacteal feeding (AHR=1.8; 95% CI=1.32-2.36) and household food insecurity (AHR=5.02; 95% CI=3.89-6.50) were significant independent factors which were associated with time to early cessation of exclusive breastfeeding. There are still sizable proportions of children not enjoying exclusive breastfeeding for the first full six months. Being an urban resident and coming from food-insecure households, giving birth by CS, having low knowledge on EBF, and giving pre-lacteal feeding were factors associated with time to early cessation of EBF. Multi-sectoral action should be taken for respective predictors of time to early cessation of EBF.

Factors Associated with Cessation of Exclusive Breastfeeding among Lactating Mothers

Factors Associated with Cessation of Exclusive Breastfeeding among Lactating Mothers

Facebook Feeds and Child Feeding: A Qualitative Study of Thai Mothers in Online Child Feeding Support Groups.

Mothers have traditionally sought child feeding information from social connections. While mothers are heavily engaged on social media and value peer support in online communities, very little is known about how they use online communities for information about child feeding practices after exclusive breastfeeding cessation. This study explores mothers’ perceptions of joining Facebook child feeding support groups. Individual semi-structured interviews with ten Thai mothers were conducted. The transcribed interviews were analyzed using a phenomenological hermeneutical approach. Our findings highlighted that Thai mothers participated in Facebook child feeding support groups in a deliberate effort to reduce their uncertainty by normalizing the process through accessing the shared experiences of others. One of their intentions was to seek menu recipes based on favorable psychosocial and environmental factors. Implications for using social media in health promotion and communication include the importance of building appropriate common practices through social collaboration and interactivity to supplement traditional knowledge and attitudes.

Impact of prelacteal feeds and neonatal introduction of breast milk substitutes on breastfeeding outcomes: A systematic review and meta-analysis.

The introduction of fluids other than breast milk during the first few days of life or later neonatal period has been identified as a risk factor for suboptimal breastfeeding (BF) outcomes in numerous studies using varying study designs. However, the relationship between early introduction of fluids other than breast milk and BF outcomes has not been systematically assessed using only prospective studies that can establish temporality, which is critical for determining whether observed associations are causal. We conducted a systematic review and meta‐analysis of prospective studies to assess if there is a difference in BF outcomes as a result of the introduction of: (a) milk‐based prelacteals, (b) water‐based prelacteals and (c) breast milk substitutes (BMS) between 4 days and 4 weeks postpartum. We searched PubMed, Lilacs, Web of Science and other repositories for original research investigating the relationship between early introduction of prelacteals and/or BMS and BF outcomes. Forty‐eight studies met the inclusion criteria for the systematic review. Of the 39 prelacteal feeding studies, 27 had the prerequisite statistical information for inclusion in the meta‐analysis. Findings from the meta‐analysis showed a relationship between prelacteals and exclusive BF cessation (RR 1.44; 1.29–1.60) and any BF cessation (2.23; 1.63–3.06) among infants under 6 months old. Nine studies focusing on the introduction of BMS during the neonatal period identified this practice as a statistically significant risk factor for a shorter BF duration. Effective interventions are needed to prevent the introduction of unnecessary milk‐based prelacteals and BMS during the perinatal and neonatal periods to improve BF outcomes.

Cessation of exclusive breastfeeding and seasonality, but not small intestinal bacterial overgrowth, are associated with environmental enteric dysfunction: A birth cohort study amongst infants in rural Kenya

SummaryBackgroundEnvironmental Enteric Dysfunction (EED) is a chronic intestinal inflammatory disorder of unclear aetiology prevalent amongst children in low-income settings and associated with stunting. We aimed to characterise development of EED and its putative risk factors amongst rural Kenyan infants.MethodsIn a birth cohort study in Junju, rural coastal Kenya, between August 2015 and January 2017, 100 infants were each followed for nine months. Breastfeeding status was recorded weekly and anthropometry monthly. Acute illnesses and antibiotics were captured by active and passive surveillance. Intestinal function and small intestinal bacterial overgrowth (SIBO) were assessed by monthly urinary lactulose mannitol (LM) and breath hydrogen tests. Faecal alpha-1-antitrypsin, myeloperoxidase and neopterin were measured as EED biomarkers, and microbiota composition assessed by 16S sequencing.FindingsTwenty nine of the 88 participants (33%) that underwent length measurement at nine months of age were stunted (length-for-age Z score <-2). During the rainy season, linear growth was slower and LM ratio was higher. In multivariable models, LM ratio, myeloperoxidase and neopterin increased after cessation of continuous-since-birth exclusive breastfeeding. For LM ratio this only occurred during the rainy season. EED markers were not associated with antibiotics, acute illnesses, SIBO, or gut microbiota diversity. Microbiota diversified with age and was not strongly associated with complementary food introduction or linear growth impairment.InterpretationOur data suggest that intensified promotion of uninterrupted exclusive breastfeeding amongst infants under six months during the rainy season, where rainfall is seasonal, may help prevent EED. Our findings also suggest that therapeutic strategies directed towards SIBO are unlikely to impact on EED in this setting. However, further development of non-invasive diagnostic methods for SIBO is required.FundingThis research was funded in part by the Wellcome Trust (Research Training Fellowship to RJC (103376/Z/13/Z)). EPKP was supported by the MRC/DfID Newton Fund (MR/N006259/1). JAB was supported by the MRC/DFiD/Wellcome Trust Joint Global Health Trials scheme (MR/M007367/1) and the Bill & Melinda Gates Foundation (OPP1131320). HHU was supported by the NIHR Oxford Biomedical Research Centre (IS-BRC-1215-20008).

Predicting Risk for Early Breastfeeding Cessation in Israel.

This study aimed to 1) Examine factors associated with cessation of exclusive breastfeeding in Israel and 2) Develop predictive models to identify women at risk for early exclusive breastfeeding cessation. The study used data from longitudinal national representative infant nutrition survey in Israel (n = 2119 participants). Logistic regression was used to identify risk factors and build predictive models. The rate of exclusive breastfeeding cessation increased from 45.4% at 2months to 85.7% at 6months. Five factors were significantly associated with higher odds of exclusive breastfeeding cessation at 2months: being a primapara, low educational level, lack of previous breastfeeding experience, negative attitude towards birth, and lack of intention to breastfeed. Six factors were significantly associated with higher odds of exclusive breastfeeding cessation at 6months: younger age, being in a relationship with a partner, lower religiosity level, cesarean delivery, not taking folic acid during pregnancy, and negative attitude towards birth. Both 2 and 6-months models had good predictive performance (C-statistic of .72 and .68, accordingly). This nationwide study successfully identified several predictors of exclusive breastfeeding cessation and created breastfeeding cessation prediction tools for two time periods (2 and 6months). The resulting tools can be applied to identify women at risk for stopping exclusive breastfeeding in hospitals or at community clinics. Further studies should examine practical aspects of applying these tools in practice and explore whether applying those tools can lead to higher exclusive breastfeeding rates.

Time to cessation of exclusive breastfeeding and associated factors among women with children aged 6-24 months in Kilimanjaro region, northern Tanzania: A community-based cross-sectional study.

BackgroundExclusive breastfeeding (EBF) up to six months is sub-optimal globally. Tanzania has surpassed the World Health Assembly (WHA) target of increasing the rate of exclusive breastfeeding among children below six months to at least 50% by the year 2025 the median age of cessation of EBF is only three months.ObjectiveTo determine the time to cessation of exclusive breastfeeding and its associated factors among women with children aged 6–24 months in Kilimanjaro region, Northern Tanzania.MethodsThis was a secondary analysis of data from a community-based cross-sectional study conducted between April 2016 and April 2017 in Kilimanjaro region, northern Tanzania. In the parent study, a multistage sampling technique was used to select study participants and interviewed using a questionnaire. Data for 1291 mother-child pairs were analyzed using STATA version 15. Kaplan-Meier method with the log-rank test estimated and compared the survivor functions across covariate levels. Cox regression proportional hazards models estimated the hazard ratios (HR) and their 95% confidence intervals (CI) for factors associated with time to cessation of exclusive breastfeeding.ResultsThe prevalence of cessation of exclusive breastfeeding before six months was 68.7%, with a median age of cessation of four months (95% CI: 3, 4). In comparison to women living in Siha district, women living in Moshi Municipal (HR = 1.61; 95% CI = 1.24, 2.09), Same (HR = 1.32; 95% CI = 1.06, 1.65) and Mwanga (HR = 1.53; 95% CI = 1.20, 1.96) districts, had higher hazards of cessation of exclusive breastfeeding before six months. Women who received breastfeeding counselling at antenatal care had a lower hazard to cease EBF (HR = 0.76, 95% CI 0.65, 087) compared to those who did not receive breastfeeding counselling.ConclusionThe median age of cessation of EBF is unsatisfactory but at least higher (four months) than the national level estimate of three months. District specific interventions and breastfeeding counselling at antenatal care are essential for improving time to cessation of exclusive breastfeeding. Promotion of adequate ANC visits remains one of the critical interventions to improve BF practices and other reproductive health outcomes.

Identification of Factors for Cessation of Exclusive Breastfeeding among Mothers of Infants

Background: For the healthy growth of a child, it is essential that the child be breastfed exclusively for 6 months and continued up to 2 years of their age. Although the practice of breastfeeding is common in India, the District Level Household and Facility Survey showed that the percentage of exclusive breastfeeding (EBF) dropped from 63% &lt;1 month to 49% under 3 months and 32% under 5 months. Aim: This study was undertaken to identify the factors for cessation of EBF among mothers in Puducherry. Materials and Methods: It was a hospital-based cross-sectional study where 80 mothers of infants who fulfilled the eligibility criteria were selected by purposive sampling technique. Fifteen factors addressing the main reasons for cessation of EBF were developed. Results: The results revealed that during the 1st month, 78 (97.5%) of the mothers provided EBF, during the 2nd month, 87.5% of the mothers provided EBF, and during the 3rd, 4th, and 5th month, 80%, 54%, and 26% of the mothers provided EBF, respectively. The factors leading to cessation of EBF by mothers were not having sufficient milk (77.5%), going back to work (51%), had too many household chores (60%), felt tired due to breastfeeding (42.5%) and baby-centered factors such as baby continuing to remain hungry even after taking breastfeed (51%), baby failed to breastfeed (47.5%), and baby not gaining adequate weight (48.5%). Conclusion: EBF continues to be low among the mothers. Strategies need to be undertaken to improve EBF.

Factors associated with early cessation of exclusive breast feeding among Saudi mothers: A prospective observational study.

Context:World Health Organization recommending initiation of breastfeeding within hour of birth, exclusive breastfeeding for the first 6 months. In Saudi Arabia, there is a paucity of studies on the factors associated with early cessation of exclusive breastfeeding.Aims:We aimed to assess the exclusive breastfeeding rates and to identify the risk factors for early breastfeeding cessation at maternal and institutional levels.Settings and Design:A prospective observational study carried out at King Abdullah bin Abdulaziz University Hospital, Riyadh, Saudi Arabia.Methods and Materials:It included all postpartum women who had given birth to full term, singleton, healthy newborns, and were breastfeeding before discharge. Data were collected before discharge, 2 weeks, and 8 weeks postpartum using an adapted instrument.Statistical Analysis:Using JMP14 software with appropriate statistical tests.Results:The study included 136 mothers, of whom 37.5% were exclusively breastfeeding in the first 2 weeks; this rate dropped to 19% with a statistically significant difference (P < 0.0001). Early breastfeeding cessation was significantly associated with maternal age, health status, mother's knowledge, and attitude, in addition to other modifiable factors that was encountered during hospital stay such as latching difficulties and introduction of formula feeding.Conclusions:This study reported low exclusive breastfeeding rates in the first 2 months postpartum among Saudi mothers. Multiple factors were associated with breastfeeding, and some are modifiable. Breastfeeding promotion and support for is a critical role required from healthcare workers in all settings, including primary health care. Healthcare professionals play a major role in promoting, protecting, and supporting exclusive breastfeeding.

\u201cI Found Out I was Pregnant, and I Started Feeling Stressed\u201d: A Longitudinal Qualitative Perspective of Mental Health Experiences Among Perinatal Women Living with HIV

Globally, depressive symptoms among pregnant and postpartum (i.e., perinatal) women living with HIV (WLWH) are alarmingly high and associated with poor outcomes such as suboptimal adherence to antiretroviral therapy (ART), and early cessation of exclusive breastfeeding (EBF). Few qualitative studies have described the experience of perinatal depression among WLWH to identify the underlying social-structural determinants of poor mental health and potential strategies to intervene. We conducted a longitudinal qualitative study applying semi-structured interviews with 30 WLWH at three timepoints (28–38 weeks pregnant, 6-weeks postpartum and 5–7 months postpartum) to understand mental health experiences of perinatal WLWH in western Kenya. Financial insecurity emerged as the central theme impacting the mental health of women across time. Financial insecurity was often attributed to the loss of employment, related to pregnancy and the demands of breastfeeding and caring for an infant, as well as a lack of support from male partners. The loss of income and subsequent financial strain contributed to worsening levels of food insecurity and relationship stress and challenged engagement in HIV care. In this way, increased financial strain during the perinatal period negatively impacted the mental health of perinatal WLWH. Our findings suggest support to meet basic needs and remain engaged in HIV care during pregnancy and postpartum could improve perinatal mental health for WLWH in this setting.

Maintenance of Maternal Breastfeeding up to 6 Months: Predictive Models.

Background: There is evidence of the benefits of exclusive breastfeeding (EBF) but maintaining EBF for the minimum recommended time of 6 months is challenging. Aims: This study aimed to determine the prevalence of breastfeeding types in a Spanish setting, explore the influencing factors, and analyze the relationships between the reasons for EBF cessation and the EBF durations achieved. Method: This longitudinal descriptive study included 236 healthy children with standard weight followed up by the public health system. A baseline survey and three telephone interviews (1, 3, and 6 months) were conducted. Results: The prevalence of EBF at 6 months was 19.49%. The mean age of the mothers was 32.3 (±5.3). The variables influencing EBF maintenance were the prior decision to practice EBF (p = 0.03), the belief that EBF is sufficient (p = 0.00), not offering water or fluid to the child (p = 0.04), delaying pacifier use (p < 0.001), a longer gestation time (p = 0.05), and previous experience with practicing EBF for more than 6 months (p = 0.00). The reason for the earliest EBF cessation (mean 52.63 ± 56.98 days) was the mother’s lack of self-efficacy (p = 0.05). Conclusion: Knowing the reasons for EBF cessation among mothers is important for helping mothers and preventing early weaning. A safe environment and support can prevent early weaning.