Exclusive Breastfeeding Rates Research Articles

How social and commercial determinants influence exclusive breastfeeding in the Philippines

Abstract Background The World Health Organization recommends exclusive breastfeeding (EBF) for the first six months after delivery. However, the EBF rate in the Philippines is only 29%. Existing literature suggests that the influence of infant formula marketing (IFM), communication channels, and traditional health beliefs are possible contributors to low EBF rates, but rare studies have been conducted in low-resource settings. Methods: To bridge the gap, 15 barangays in Palawan were selected; 97 interviews were conducted with lactating mothers (LM), health workers (HW), traditional healers, infant formula sellers, and community leaders (CL) to represent different perspectives. The results were coded and analyzed inductively. Results LM received EBF information through multiple resources. Poverty, lacking breast milk (BM), EBF education, and health benefits (HB) to infants are top contributors to EBF while maternal employment and no BM are top barriers to EBF. Elders, traditional health beliefs (THB), and the influence of COVID-19 can influence EBF in both directions. LM emphasized more on poverty and elders to EBF while HW and CL emphasized the role of EBF education and HB. Urban LM tend to have more regular EBF education, use pumps when going out, and are more influenced by IFM. LM in remote areas tend to have more THB, have more BM substitutes, and share BM. Social classes, locations, Indigeneity, migration, and poverty are intersectioned to influence EBF. Conclusions Multiple social and commercial determinants influenced EBF. LM is facing more challenges to EBF under globalization and capitalism. Remote LM are less benefited from new technologies and policies to promote EBF. Different stakeholders have echo chambers to perceive the determinants of EBF. To improve health equity and EBF, the situations of marginalized people in remote areas should be more considered in policy making. Community building should also be considered differently to assist in EBF. Key messages • The project focuses on social and commercial determinants of exclusive breastfeeding with people in extreme poverty. • The project includes plenty of Indigenous breastfeeding behavior that are underreported.

Maternal employment characteristics as a structural social determinant of breastfeeding duration

Abstract Background The European Region exhibits the world’s lowest exclusive breastfeeding rate at 6 months. Addressing work-related breastfeeding challenges is crucial, particularly for women navigating precarious work situations, compounding their adversity. This scoping review surveys research on maternal employment characteristics facilitating breastfeeding continuation post-return to work in the European Region. Methods Studies from 2013 to 2023 were gathered from Scopus, PubMed, and PsycInfo. Inclusion criteria comprised English or French quantitative/qualitative studies exploring links between maternal employment characteristics and breastfeeding status, duration, or experience. Participants were employed mothers of healthy children sustaining breastfeeding post-resumption of work. Key determinants included work-related factors contributing to socially diverse working conditions, encompassing type of employment, working conditions, and work environment. Geographic scope included World Health Organization European Region countries. Results Among 693 hits, 13 studies met criteria. Eight focused on work and breastfeeding, others explored broader breastfeeding determinants. Represented countries: Spain (n = 4), France (n = 4), UK (n = 2), Ireland (n = 2), Netherlands (n = 1). Findings highlighted methodological heterogeneity, indicating a lack of conceptual framework linking work, breastfeeding, and social health inequalities. Nonetheless, self-employment, non-manual professions with time flexibility, workplace breastfeeding facilities, coworker support, and breastfeeding workplace policies emerged as pivotal factors supporting working mothers’ breastfeeding. Conclusions Backing breastfeeding choices for working mothers is crucial amid adversities faced by mothers and children. These results underscore the need for targeted workplace interventions, including time flexibility, breastfeeding facilities, and promotion of breastfeeding-friendly policies. Key messages • Self-employment, non-manual occupations, time flexibility, breastfeeding facilities, support of co-workers and breastfeeding workplace policies promote continuation of breastfeeding. • Policy directives targeting low skilled or precarious jobs are needed to reduce social health inequalities broadly, and in particular, in relation to breastfeeding practices.

Promotion of breastfeeding in Italian Maternity Hospitals: a pre-intervention study

BackgroundIn Italy, exclusive breastfeeding (EBF) rates at hospital discharge range unsatisfactorily between 20–97%.MethodsIn 2023, the Project for Hospital Policy on Breastfeeding (HPB) has been launched to promote breastfeeding in Italian Maternity Hospitals (MHs) as a joint initiative of the Italian Scientific Societies involved in perinatal care together with the National Midwife (FNOPO) and Nurse (FNOPI) Boards and with Vivere Onlus, a family association. The HBP Project has been designed as an uncontrolled before-after study to increase EBF rate at hospital discharge in the population of healthy, term infant with a normal weight at birth following an intervention bundle comprising: 1) Establishment of a local hospital Working Group; 2) Adoption of a hospital policy; 3) Implementation of breastfeeding monitoring; 4) Training for perinatal care professionals; 5) Enhanced implementation of the practices of skin-to-skin contact (SSC) and mother-baby rooming-in; 6) Development/Improvement of perinatal care protocols.ResultsWe report the pre-intervention assessment of 89 out of the 111 enrolled MHs (80.2%) at the beginning of the Project (Time 1 or T1). Almost all MHs (96.6%) have a multi-professional Breastfeeding Working Group, while a hospital policy on breastfeeding is available only in 48.2%. Moreover, only 56.2% of the 9,777 perinatal health workers have been trained in breastfeeding. Over a 1-month period, SSC has been practiced in the delivery room by 76.9% of 6,304 term healthy newborn infants and rooming-in by 83.4% of 6,735 healthy term newborns of normal weight at birth. Over a 4-month period, 69.1% of 33,367 healthy term newborns of normal birth weight were exclusively breastfed at hospital discharge. Noticeably, EBF rate of MHs ranges from 4% up to 100%, the second quartile being 73%.ConclusionAt T1 of the HPB Project, breastfeeding rates at hospital discharge for healthy, term infants with a normal weight at birth appear to be suboptimal among Italians MHs. Particularly, the range of EBF rates among participating centers is wide, with 50% of the MHs having EBF rate lower than 73%. Therefore, the ongoing HPB Project might represent not only an opportunity to increase the initiation of breastfeeding and to improve quality of health care in the whole study group of MHs, but possibly also to level differences between centers.

Knowledge, Attitudes, and Practices Regarding Exclusive Breastfeeding among Lactating Mothers in Rural Bangladesh

Background: Exclusive breastfeeding stands at the forefront of maternal and child health, serving as a fundamental pillar for ensuring the optimal growth and development of infants. It not only acts as a crucial source of nutrition but also plays a pivotal role in fortifying the physical and cognitive well-being of newborns, while simultaneously fostering a profound bond between mothers and their infants.Objective: This research seeks to gauge the level of awareness among lactating mothers regarding the significance and benefits of exclusive breastfeeding. It aims to comprehend their attitudes towards exclusive breastfeeding (EBF) and scrutinize their actual practices in implementing this vital aspect of infant care.Materials and Methods: A cross-sectional study was conducted at the Department of Community Medicine, ASWMC, Jashore, in 2018. Data collection took place in the Outpatient Department (OPD) of 'Ad-din Sakina Medical College Hospital' and 'Mother & Child Welfare Centre, Jashore.Results: The study demonstrates a high awareness and adherence to exclusive breastfeeding, with 94.4% aware, 90.9% knowledgeable about recommended duration, 49.9% recognizing advantages, 14.6% aware of disadvantages, and a substantial majority (92.5%) practicing exclusive breastfeeding, though 7.5% do not.Conclusion: Bridging knowledge gaps, cultivating positive attitudes, and promoting consistent breastfeeding practices emerge as crucial components of a comprehensive strategy to boost exclusive breastfeeding rates. The collaboration between healthcare providers, policymakers, and the community is indispensable for the success of such initiatives, ultimately contributing to the overall health and well-being of both infants and lactating mothers. KYAMC Journal Volume: 15, No: 01, April 2024: 46-49.

Breastfeeding Behaviors by Race/Ethnicity and Foreign-Born Status in the United States: An Analysis of the U.S. National Survey of Children's Health.

Objective: The foreign-born population is growing in the United States, but no nationally representative statistics of breastfeeding behavior disaggregated by race/ethnicity and foreign-born status have been published in recent years. This study examines breastfeeding initiation, any breastfeeding, and exclusive breastfeeding at 3 and 6 months among foreign-born and U.S.-born Non-Hispanic (NH) Black, NH White, and Hispanic women in the United States. Methods: This is a cross-sectional study utilizing years 2021 and 2022 of the National Survey of Children's Health. Sample children identified as NH White, NH Black, and Hispanic who were 6 months to 5 years old and residing with their biological or adoptive mother were included (n = 27,818). Results: Foreign-born women in all racial/ethnic groups (NH Black, NH White, and Hispanic) had significantly higher odds of any breastfeeding at 6 months relative to U.S.-born NH White women. However, they did not have significantly different odds of exclusive breastfeeding for 6 months relative to U.S.-born NH White women. U.S.-born Hispanic women had rates of exclusive breastfeeding for 6 months (23.2%) that were much closer to U.S.-born NH Black women (23.4%) than to foreign-born Hispanic women (29.4%) or U.S.-born White women (32.1%). Conclusions: The large percentage of foreign-born women who reported some breastfeeding at 6 months indicates a strong commitment to breastfeeding and may be a leverage point for future exclusive breastfeeding interventions among this group. U.S.-born Hispanic women appear to be struggling with exclusive breastfeeding and may need additional interventions.

Father support breastfeeding self-efficacy positively affects exclusive breastfeeding at 6 weeks postpartum and its influencing factors in Southeast China: a multi-centre, cross-sectional study

BackgroundThe exclusive breastfeeding condition in China is not optimism now. Maternal breastfeeding self-efficacy stands as a pivotal factor influencing exclusive breastfeeding. Interestingly, studies have suggested that father support breastfeeding self-efficacy is a pivotal mediator in infant breastfeeding. Thus, the current research aimed to investigate the association between father support breastfeeding self-efficacy and exclusive breastfeeding at six weeks postpartum, and the influencing factors of father support breastfeeding self-efficacy.MethodsThis research was structured as a multi-centre cross-sectional study, involving 328 fathers, whose partners were six weeks postpartum, and recruited from two public hospitals in Southeast China. Self-designed demographic questionnaires, namely, Father Support Breastfeeding Self-Efficacy Scale-Short Form, Breastfeeding Knowledge Questionnaire, Positive Affect Scale and the 14-item Fatigue Scale, were applied. Descriptive statistics, Chi-square test, logistic regression univariate analysis and multiple linear regression were used to analyse data.ResultsResults indicate a significant difference between the infant feeding methods at six weeks postpartum and fathers with different levels of support breastfeeding self-efficacy (p < 0.05). Particularly, father support breastfeeding self-efficacy positively affected exclusive breastfeeding at six weeks postpartum after adjusting all the demographic characteristics of fathers (OR: 2.407; 95% CI: 1.017–4.121). Moreover, results show that the significant influencing factors of father support breastfeeding self-efficacy include breastfeeding knowledge, fatigue, positive affect, successfully experienced helping mothers to breastfeed, spousal relationships and companionship time.ConclusionsHigh-level father support breastfeeding self-efficacy effectively increased exclusive breastfeeding rate at six weeks postpartum. To enhance the exclusive breastfeeding rate, nurses or midwives can endeavour to design educational programmes or take supportive interventions customised for fathers, such as enhancing their breastfeeding knowledge education, reducing fatigue and mobilising positive emotions, thereby bolstering paternal self-efficacy in breastfeeding.

Breastfeeding Practices in the Twin Town of India - A Cross-Sectional Study.

The global rise in twinning rates poses health challenges due to increased risks for infants and mothers. Despite the benefits, breastfeeding rates among multiples are low, with exclusive breastfeeding (EBF) particularly scarce compared to singletons. Our study focuses on the mothers of twins in a unique population in Kodinhi village, Kerala, India, known for its high twinning rates, which aims to contribute to existing knowledge of breastfeeding practices and perspectives in a high twinning environment and offer valuable insights to promote optimal breastfeeding among mothers of twins. A retrospective cross-sectional survey was adopted. Seventy-five mothers with twins under 3 years of age from Kodinhi and neighboring areas were interviewed face to face using structured validated tools. Data collection focused on quantitative data supplemented by narrative descriptions. Most women delivered preterm (57.3%), operative delivery (58.7%), and had a late initiation of breastfeeding (32.9% within 24 hours). Colostrum feed was common (86.7%). The EBF rate was 4%, with 47.9% initiating nonexclusive breastfeeding before 3 months, and most of the twins (46.6%) were breastfed for 1-2 years. Fatigue (69.9%) and low milk supply (38.7%) were chief concerns. While 16.4% of mothers opted for a tandem breastfeeding technique, many preferred consecutive feeding as tandem was challenging. Mothers in Kodinhi demonstrated commendable efforts in breastfeeding twins; despite the low rate of EBF, breastfeeding extended to 1-2 years. Evidence-based interventions and personalized support, primarily focusing on maternal perspectives of milk insufficiency, fatigue and breastfeeding techniques, are crucial for sustaining optimal breastfeeding practices among mothers of twins.

Effect of continuity of team midwifery care on maternal and neonatal outcomes: a quasi-experimental study in Iran

Midwife-led continuity of care models have been linked to better clinical outcomes in certain developed countries. However, there is a paucity of research on these models in developing nations. This quasi-experimental study was conducted on primiparous women who referred to one private midwifery center and two public hospitals in Ahvaz, Iran to evaluate the effect of team midwifery care on maternal and neonatal outcomes of pregnant women in Iran. Two hundred women were allocated either into the experimental (n = 100) or control (n = 100) groups. Women in the experimental group, received team midwifery care, while women in the control group, received routine care. Data were collected using a demographic questionnaire, Mackey questionnaire, and a checklist. Women in the team midwifery care group experienced significantly higher rates of normal vaginal birth and exclusive breastfeeding compared to women in the control group. No statistically significant difference was observed between the two groups in terms of the rate of induction of labor and postpartum hemorrhage. The duration of labor was longer in the team midwifery care compared to the control group. Women in the team midwifery care group had a significantly higher rate of exclusive breastfeeding at six weeks postpartum compared to the control group (80 vs. 61%, p = 0.001). After excluding women with ruptured membranes and prolonged pregnancies, neonates in the intervention group had significantly higher first- and fifth-minute Apgar scores (p < 0.0001), and a lower rate of admission to intensive care unit in the intervention group compared to the control group (1 vs. 9%, p = 0.04). Also, women in the team midwifery group had skin-to-skin contact significantly earlier than those in the control group (33.87 ± 66.26 min vs. 111.98 ± 247.31 min, p = 0.578). Given the positive impact of continuous team midwifery care on maternal and neonatal outcomes, its implementation in maternity care systems, particularly in countries like Iran with high cesarean section rates, is strongly recommended.

Prenatal Breastfeeding Education with or without Hand Expressing Human Milk and Breastfeeding Duration in a Rural Population.

The benefits of breastfeeding are well recognized. However, exclusive breastfeeding (EBF) rates are well below the Healthy People 2030 Guidelines, with a rapid drop in exclusive breastfeeding over the first 3 months of life. Although breastfeeding support has increased the initiation of breastfeeding, the role of perinatal interventions, particularly in the context of breastfeeding support, remains a topic of contradiction. This observational study was designed to assess the impact of a unique prenatal educational intervention in rural East Texas. The study had two aims: (1) to determine whether the addition of prenatal breastfeeding education increased the rate of exclusive breastfeeding at four time points, and (2) to assess the impact of hand expression education on breastfeeding exclusivity. Differences in breastfeeding behaviors were seen between those who received the education and those who did not for exclusivity and duration of breastfeeding. Participants who received the hand expression education were 1.79 times more likely to continue EBF practices at three months postpartum, 6.27 times more likely to continue EBF practices at six months postpartum, and 3.34 times more likely to continue breastfeeding at twelve months postpartum than those who did not receive any hand expression education. This study demonstrates that prenatal education is beneficial for increasing breastfeeding exclusivity and duration and underscores its potential to improve maternal and infant health outcomes. Further research is needed to resolve the ongoing debate and advance our understanding of interventions to increase breastfeeding duration.

The Effect of Baby Friendly Neonatal Intensive Care Initiative on Exclusive Breastfeeding Rates following Discharge in Very Preterm Infants.

We aimed to investigate the effect of "Baby Friendly NICU" practice on exclusive breastfeeding rates following discharge in very preterm infants. The Baby-Friendly Hospital Initiative (BFHI) is a global program launched by the World Health Organization (WHO) and UNICEF. The feeding technique, type of nutrition (breastfeeding, formula, mixed) and anthropometric measurements of the very preterm infants (≤32 gestational weeks) were recorded for every month following discharge up to corrected 6months of age. Exclusive breastfeeding rates were compared between 2 periods before "Baby Friendly NICU" practice (group 1) and after (group 2). Data of 252 infants, 135 in group 1 and 117 in group 2 were analyzed. Exclusive formula feeding rates decreased by 6months age in group 2 (46 vs. 32%, P =.02); however, exclusively breastfeeding rates did not changed significantly (20% vs. 29%, P =.14). Baby friendly NICU practices significantly decreased formula feeding rates at 6months; however, it did not have an effect on exclusive breastfeeding rates at any time point during follow-up probably due to small sample size.

Maternal Care of Preterm Infants after Discharge from the Neonatal Intensive Care Unit: A Rapid Review

Abstract The maternal care of infants poses a unique challenge for mothers, especially after discharge from the hospital. This review focused on the literature on maternal care of preterm infants at home after discharge from the hospital’s Neonatal Intensive Care Unit (NICU). A comprehensive literature search was conducted using keywords relevant to the topic. PubMed and EBSCO essential databases were searched for studies published between 2017 and 2023 (six years). Out of the 2903 retrieved studies, 7 were eligible and included in the review. The quality of available evidence was assessed using the Johns Hopkins Nursing Evidence Appraisal Tool (JHNEAT) and the Critical Appraisal Skills Programme (CASP) checklist. This review found that exclusive breastfeeding rates for preterm infants at home varied from 27% to 76% (Pooled prevalence of 48%) in data extracted from the studies conducted in Ethiopia (Africa), Brazil (South America), USA (North America), Denmark, and Italy (Europe). The practice of kangaroo mother care (KMC) for temperature regulation ranged from 41% to 83% (Pooled prevalence of 63%) in data extracted from studies conducted in Ethiopia (Africa) and Denmark (Europe). The review concluded that the care provided by mothers at home after discharge from the NICU was inadequate. Maternal and child health services providers should develop social media platforms to educate and encourage mothers to sustain exclusive breastfeeding and KMC practices after leaving the NICU.

The effect of on-site and on-call nurse on exclusive breastfeeding in two different hospital settings: a prospective observational cohort study

BackgroundExclusive breastfeeding during postpartum hospitalization is very important for ensuring the success of breastfeeding at home. The aim of the study is to determine if the on-site nurse in rooming in improves exclusive breastfeeding ratio.MethodsWe conducted a prospective observational cohort study to evaluate exclusive breastfeeding during the first three months of life in two Neonatology Units in the South of Italy with different hospital settings: Ente Ecclesiastico Miulli of Acquaviva delle Fonti with on-site nurse h24 (on-site group) and Policlinico of Bari with nurse available on call h24 from Neonatology Unit (on-call group).ResultsA total of 564 mother-baby dyads were admitted from 3 January to 31 March 2018 (299 in on-site group and 265 in on-call group). In the overall population, exclusive breastfeeding rate was 76.4% at 90-days, confirming the role of nurse and rooming in, independently of modality of setting. Considering the way of delivery, in infants from cesarean section there were higher rates for exclusive breastfeeding at 30 and 90 days of life in on-site group.ConclusionsWe can assume that the presence of a nurse h24 could better identify breastfeeding problems. Our study suggests the role of on-site nurse during rooming in to encourage exclusive breastfeeding until three months of life in mothers who underwent caesarean section.

Oral dextrose gel for hypoglycemia in a well-baby nursery: a baby-friendly initiative.

To assess the impact of oral dextrose gel (ODG) treatment on NICU admission rates for hypoglycemic infants in a well-baby nursery. We retrospectively compared newborn infants at risk for hypoglycemia born during the intervention period (n = 3775) with historical controls (n = 655). We also compared the rates of the primary outcome (NICU admission) and secondary outcomes (exclusive breastfeeding and hospital costs) between the two periods. Following the implementation of ODG supplementation, the NICU admissions rates dropped from 4% to 2%, p < 0.05, for at-risk infants and from 15% to 7%, p < 0.05, for hypoglycemic infants in the baseline and intervention periods, respectively, with an adjusted OR (95% CI) of 0.39 (0.24-0.64), p < 0.001. Additionally, the ODG protocol sustained rates of exclusive breastfeeding in contrast to the institutional protocol. The adoption of an ODG protocol fosters a more nurturing and baby-friendly environment through reduced NICU transfers, support for exclusive breastfeeding, and decreased hospital costs.

Role of proper postnatal care in continued exclusive breastfeeding among young Indonesian mothers.

Exclusive breastfeeding (EBF) provides numerous health benefits to children. However, the EBF rate is unsatisfactory among young mothers because they often experience difficulties. Thus, interventions during the postnatal period are imperative to encouraging EBF practices in these populations. Postnatal care (PNC) should be delivered appropriately to ensure a positive postnatal experience; however, there has been little discussion of evidence therein to date. This study investigated the association between proper PNC and EBF practices among young Indonesian mothers. This cross-sectional study analyzed data from the 2017 Indonesia Demographic Health Survey. All mothers aged 15-24 years who delivered an infant within the 2 years preceding the survey were included. Mothers were considered to be receiving proper PNC if they started breastfeeding soon after delivery, attended a PNC appointment within 2 days after giving birth, and received breastfeeding counseling and observation during the PNC visit. Approximately 51.6% of infants under 6 months of age born to young mothers (those aged 15-24 years) were exclusively breastfed. Appropriate PNC was received by approximately 24.3% of the total population. The correlation between proper PNC and EBF practices was significant among adolescent mothers aged 15-19 years after an age stratification analysis (odds ratio, 8.22; 95% confidence interval, 1.957-34.524). Maternal age became a noticeable confounder after a risk stratification analysis. Our findings imply the importance of breastfeeding service delivery during the early postnatal period in continuing EBF. Ensuring high PNC quality helps ensure positive postnatal experiences, particularly for adolescent mothers.

Development of a breastfeeding co-parenting intervention program for couples with primiparas: a program development process study

BackgroundThe exclusive breastfeeding rates is low in some countries. Low breastfeeding rates results in higher healthcare expenses and adverse health outcomes for individuals and society. Co-parenting is effective in promoting breastfeeding as it involves shared responsibility and collaboration between parents in raising children. However, the current breastfeeding co-parenting intervention programs exhibits significant variations in components, timing, and duration across studies. An evidence-based breastfeeding co-parenting intervention program is essential for enhancing breastfeeding-related outcomes.ObjectiveTo develop an evidence-based breastfeeding co-parenting intervention program for healthcare providers to guide parents with primiparas on breastfeeding.MethodTo form an initial version of the intervention program, a systematic literature review was conducted to consolidate information on current intervention programs. Two rounds of Delphi method were followed to gather expert comments for the program modification to establish the formal version.ResultsFourteen articles published between 1995 and 2022 were screened. Details of these researches, including starting and ending time, duration and specific contents, were integrated to developed the initial program. Then, six experts completed the two rounds consultation with a positive coefficient of 85.71%, coefficient judgment basis of 0.93, familiarity coefficient of 0.87, authority coefficient of 0.90 and the Kendall’s W of 0.62. Finally, an evidence-based breastfeeding co-parenting intervention program was constructed in this study, consisting of breastfeeding co-parenting courses, individual counselling and a father’s support group.ConclusionThis research developed a breastfeeding co-parenting intervention program for healthcare providers to guide primiparous parents to improve breastfeeding rates. Through a systematic literature review and Delphi method with good reliability, the program integrates breastfeeding courses, individual counseling, and a father’s support group. Future research will focus on evaluating its impact and scalability to benefit maternal and infant health globally.Trial registrationChiCTR.org.cn (ChiCTR2300069648). Registration date: 2023-03-22.

Association between breastfeeding duration and BMI, 2009-2018: a population-based study.

In the 21st century, childhood overweight and obesity have become major public health issues worldwide. Previous studies have shown that breastfeeding helps prevent overweight or obesity in children. Despite the significant advantages of breastfeeding, the global exclusive breastfeeding rate for infants under 6 months old is only 40%, while in the United States, the rate is only 25%. The aim of this study is to explore the relationship between breastfeeding duration and BMI in children aged 2 to 6 in the United States, and to raise awareness of breastfeeding. A cross-sectional study included 2,769 participants between the ages of 2 and 6 from a sample that represented the entire NHANES 2009-2018. Data was analyzed using EmpowerStats, (www.empowerstats.com) linear regression as well as Chi-square test, t-tests, multivariate regression analysis and smooth cure fitting were done. Breastfeeding duration long-term group exhibited a statistically significant negative association with BMI, with a regression coefficient of -0.21 (P < 0.05). The continuous analysis of breastfeeding duration by tertile also demonstrate a statistically significant negative association with BMI. Subgroup analysis revealed that the potential benefits of breastfeeding on BMI were more obvious in low-income environments and maternal age 18 to 35 years, with a regression coefficient of -0.57 and -0.24, respectively (all P < 0.05). The findings emphasize the importance of breastfeeding in reducing childhood overweight/obesity and preventing associated diseases, both in clinical and public health settings.

Exclusive Breastfeeding Rates Upon Hospital Discharge at a Tertiary Centre Prior to and During the COVID-19 Pandemic

This study aimed to describe exclusive breastfeeding (EBF) rates at discharge at Sunnybrook Health Sciences Centre and explore factors that contributed to changes in breastfeeding rates during the COVID-19 pandemic. Overall, 4762 patient charts were reviewed, 2000 from the pre-pandemic period, and 2762 from the lockdown period. Data was collected on EBF status at discharge, on maternal health history, and on infant characteristics. EBF rates fell from 75.8% to 73.85% from the pre-COVID-19 to COVID-19 period. During the pandemic, EBF was positively associated with BMI <30, spontaneous conception, and infants at risk of low blood sugar. Non-spontaneous conception was associated with lower EBF.

Knowledge, Attitude, and Practice of Breastfeeding among South Indians: A Cross-sectional Study

Introduction: Research shows that exclusively breastfed infants have a 13% lower mortality risk. However, only 37% of infants in Low and middle income country (LMIC) are exclusively breastfed. Materials and Methods: This cross-sectional study was conducted in a Chennai hospital’s outpatient department, focusing on pediatrics. The study commenced after obtaining ethical clearance (99/IEC-SMMCHRI). Breastfeeding knowledge, attitude, and practice (KAP) scales were developed by modifying existing KAP tools. The KAP questionnaire was based on the World Health Organization. The same was applied to 250 consenting mothers. Results: Participants had a mean age of 27 years, with the youngest mother at 19 and the oldest at 40. Forty-one percent had finished high school, and 37% had completed undergraduate studies. Eighty-eight percent had strong breastfeeding comprehension, and 96% had a favorable attitude. However, only 32% exclusively breastfed. The study found significant correlations between knowledge and behavior (χ2 = 4.27, P = 0.04) and between attitude and behavior (χ2 = 5.69, P = 0.017). Mothers with adequate knowledge tended to follow recommended feeding practices, and those with a positive attitude displayed good practices. Conclusion: Despite positive attitudes toward breastfeeding, the cultural practice of introducing prelacteal food hinders exclusive breastfeeding, leading to negative outcomes. While there have been some improvements in exclusive breastfeeding rates, addressing this disparity could reduce child mortality rates. The outcomes of the research will be highly beneficial for primary care physicians in their efforts to promote exclusive breastfeeding among expectant mothers.

An economic evaluation on sub-optimal breastfeeding in Hong Kong: Infant health outcomes and costs.

This study estimated the healthcare cost savings for the government due to the prevention of gastroenteritis (GE) infections and lower respiratory tract infections (LRTI) in the first year of life, attributed to an increase in the exclusive breastfeeding rate at 4 months in Hong Kong. The model used the best available data inputs, with uncertainty considered using probabilistic sensitivity analysis. We additionally assessed the impact of neonatal jaundice (NNJ) on the economic benefits of increasing exclusive breastfeeding rates. During 2010-2019, five admissions for GE and three admissions for LRTI per 1000 births would have been prevented in the first year of life if the exclusive breastfeeding rate at 4 months increased from the actual levels (~15-30%) to 50%, resulting in annual healthcare cost savings of USD1.05 (95% CI 1.03-1.07) million/year. The cost saving would reach USD1.89 (95% CI 1.86-1.92) million/year if the exclusive breastfeeding rate at 4 months increase to 70%. However, if higher NNJ admissions during 7-90 days related to more exclusive breastfeeding are considered, the cost saving would reduce by 60%. Our findings can guide policymakers in allocating budget and resources for breastfeeding promotion in Hong Kong. The prevention of unnecessary NNJ admissions would maximise the economic benefits of exclusive breastfeeding at 4 months.

Maternal Work and Infant Feeding Practices in the First 6 Months.

The purpose of this study was to examine the relationship between maternal work and infant feeding practices and explore the moderating impact of parental stress. Prospective data on categorical hours worked and infant feeding practices were collected at 3 and 6 months postpartum in a prospective prenatal cohort of 95 women. Chi-square tests were used to compare change in proportion of exclusive breastfeeding from birth to 6 months and maternal work status. Rates of exclusive breastfeeding significantly decreased from birth to 6 months, while the percent of mothers working outside of the home significantly increased from 3 to 6 months. At 6 months, mothers who worked full time pumped significantly more than their non-working counterparts. Multivariate logistic regression models were used to test the prediction of exclusive breastfeeding by maternal work, including sociodemographic covariates, and the moderating impact of parental stress. Results indicated that maternal education, paternal education, and maternal work significantly predicted exclusive breastfeeding at 6 months. Full time work (OR = 0.09, 95% CI = 0.01, 0.62) was associated with a decreased odds of exclusive breastfeeding. Additionally, higher maternal (OR = 1.44, 95% CI = 1.05, 1.97) and paternal (OR = 1.28, 95% CI = 1.00, 1.66) education was associated with an increased odds of exclusive breastfeeding. Maternal stress did not predict exclusive breastfeeding, nor did it have a moderating effect on the relationship between maternal work and breastfeeding. Future studies should investigate maternal work in more diverse birthing populations to better understand how families can incorporate breastfeeding as a primary infant feeding practice.