Exclusive Breastfeeding Research Articles

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.

The Comparison of Inverse Gaussian and Gamma Regression: Application on Stunting Data in Jepara

Many research data have distributions other than the normal distribution, called exponential family distributions. The exponential family of distributions includes the inverse Gaussian and Gamma distributions. There are parallels between these two distributions in terms of the kind of random variable and how well they work. Finding the optimal model using inverse Gaussian and Gamma regression on stunting data in Jepara is the goal of this study. Maximum Likelihood Estimation is used for parameter estimation, Maximum Likelihood Ratio Test is used for simultaneous parameter testing, and Wald testing is used for partial parameter testing. For this case, the best model is inverse Gaussian regression. Exclusive breastfeeding, low birth weight babies, clean drinking water facilities, and the number of Integrated Service Post (Posyandu) influence the percentage of stunting in Jepara..

Determinants of Stunting in The Under-five in West Nusa Tenggara Province with Multilevel Binary Logistic Regression

Stunting is a form of malnutrition in children that is still a health problem in Indonesia, especially in NTB Province. Based on the results of the SSGI, the prevalence of stunting in children under five years of age in NTB Province was 32.7 percent, up 1.3 percent compared to the previous year. This value has not reached the threshold of 20 percent and the national target of 18.4 percent. This puts NTB Province in the fourth highest position in Indonesia. In 2022, NTB Province recorded the highest percentage in Indonesia for children under six months who received exclusive breastfeeding, which was 79.69 percent. However, the prevalence of stunting in toddlers in NTB Province is still very high. Between districts/cities in NTB Province, there is a fairly high disparity in the prevalence of stunting in children under five years of age. This shows the influence of regions or households so that there is a disparity in the prevalence of stunting in children under five years of age. This study aims to describe the incidence of stunting in toddlers in general and analyze the variables that influence it and its tendencies in NTB Province in 2022 using a multilevel binary regression model. The results of the study showed that the variables of toddler gender, toddler age, history of toddler pneumonia, maternal education level, access to clean drinking water sources, access to proper sanitation, and GRDP per capita had a significant effect

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.

Factors affecting infant feeding choices with a focus on barriers to exclusive breastfeeding in Western Jamaica: a qualitative study

BackgroundDespite the many benefits of exclusive breastfeeding to infants and mothers, only 33% of Jamaican infants are exclusively breastfed up to the recommend six months. This study was conducted to identify factors affecting mothers’ feeding choices focusing on barriers to exclusive breastfeeding of infants six weeks to less than six months old.MethodsA qualitative study consisting of four focus group discussion sessions was conducted among 22 mothers attending postnatal clinics in western Jamaica from May to August 2016. The transcripts were coded by three independent coders and content analysis conducted to generate themes.ResultsFour themes were identified namely, perceived advantages of breastfeeding centered mainly on the benefits of breastfeeding for the infant and mother, perceived barriers of breastfeeding highlighting physical pain and fatigue, supplementing culturally acceptable complementary foods and herbal remedies, and cultural norms including perception of how breastfeeding affects a woman’s body, societal sources of breastfeeding information, satiation of infants, and family and other support. Mothers overwhelmingly agreed that breastfeeding was inexpensive, allowed them to bond with their infants and was good for the overall health and intellectual development of the infants. They identified painful nipples, engorged breasts, lack of sleep, physical exhaustion and pressure to return to work as barriers to breastfeeding. Mothers named a number of complementary foods, such as pumpkin, carrots, potato, banana, and chocho (Chayote), that were culturally accepted for feeding infants in Jamaica and discussed herbs that were considered to aid in infants’ nutrition and overall health. Other cultural factors that were noted to influence exclusive breastfeeding were mothers feeling that breastfeeding would help their bodies, especially their bellies, go back to their pre-maternity figure, sources of breastfeeding information in the society including the internet, belief that breast milk alone does not satisfy babies, and family and other support.ConclusionMothers in this study identified unique challenges to exclusive breastfeeding that if addressed, would help to increase exclusive breastfeeding so that the World Health Organization’s exclusive breastfeeding recommendations can be achieved.

Evaluation of freezing, ultra-cold freezing, and freeze-drying on the main components of human breast milk

Breastfeeding is the ideal food during the first two years, but only 31 % of children under six months of age receive exclusive breastfeeding, below the global recommendation. Alternative methods to direct breastfeeding have been used, including the creation of personal milk banks and the practice of deferred breastfeeding. This research aimed to evaluate the changes in human breast milk composition under freezing, ultra-cold freezing, and freeze-drying conditions in terms of: 1) carbohydrate profile as lactose and Human Milk Oligosaccharides; 2) protein quantity and characteristics (total crude protein, free amino nitrogen, in vitro digestibility, electrophoretic profile and secondary structure), and 3) functional and physicochemical components/ characteristics as pH, density and moisture, as well as pro- and anti-inflammatory cytokines and levels of secretory immunoglobulin A. With different preservation methods, no differences were detected in pH, density, moisture, total crude proteins, cytokines, four Oligosaccharides (3’-Sialyllactose, 6’-Sialyllactose, Lacto-N-Tetraose, and Lacto-N-neoTetraose), and secretory immunoglobulin A. The immunological components remain stable when frozen at –20 and −80°C and during freeze-drying, allowing women to prolong breastfeeding without changing the carbohydrate, protein, and functional or physicochemical main profile. Our results improve the understanding of human breast milk quality when alternative preservation methods are required beyond direct breastfeeding, aiming to extend the duration and rates of breastfeeding.

Determinants of exclusive breastfeeding among infants under six months in Nepal: multilevel analysis of nationally representative household survey data

BackgroundThe benefits of exclusive breastfeeding (EBF) have been universally documented, with evidence of positive impacts on a child’s optimal growth, development, and survival. However, EBF practices in Nepal have fluctuated and declined over the last 25 years. In addition to the individual factors of mothers and infants, EBF practices are affected by multiple community-level factors. Understanding these factors is essential for designing breastfeeding promotion programs to improve child nutritional status in Nepal. This study investigated the individual- and community-level determinants of EBF practices among young infants aged 0–5 months in Nepal.MethodWe used the dataset from the Nepal Demographic and Health Survey 2022. Information on EBF in the past 24 h was available for 540 infants aged 0–5 months. A multilevel mixed-effect logistic regression was used to identify individual- and community-level factors associated with EBF among infants aged 0–5 months in Nepal.ResultsThe 24-hour prevalence of EBF among infants aged 0–5 months was 57.46% (95% confidence interval (CI): 52.18, 62.57). The infant’s age was inversely associated with EBF prevalence at the individual level. Compared with infants aged < 1 month, infants aged three months (adjusted odds ratio (AOR): 0.14, 95% CI: 0.05, 0.40), four months (AOR: 0.11, 95% CI: 0.04, 0.28), and five months (AOR: 0.07, 95% CI: 0.03, 0.20) were less likely to receive EBF. At the community level, community-level variables such as ≥ 4 ANC visits coverage, maternal employment status, and poverty level were generated by aggregating the individual characteristics in a cluster and were categorized using quartiles into low (“< 25%”), moderate (25–75%), and high (≥ 75%). Mothers from communities with moderate ≥ 4 ANC visits (AOR: 3.30, 95% CI: 1.65, 6.57) and high ≥ 4 ANC visits (AOR: 2.70, 95% CI: 1.40, 5.22) coverage had higher odds of EBF practices than did those from communities with low ≥ 4 ANC visits coverage. Similarly, communities with moderate (AOR: 2.67, 95% CI: 1.34, 5.30) and high (AOR: 2.34, 95% CI: 1.10, 4.99) levels of maternal employment status and moderate levels of poverty (AOR: 2.20, 95% CI: 1.13, 4.28) were associated with a higher likelihood of EBF practices. Subnational level variation was evident, with infants in Lumbini province having lower odds of EBF (AOR: 0.32, 95% CI: 0.13, 0.77) relative to Koshi province. Approximately 9% of the variation in EBF practices was observed among mothers while mapping across clusters in this study.ConclusionVarious individual- and community-level factors influence the uptake of EBF in Nepal, underscoring the need to improve the approaches and strategies of EBF programs. This study highlighted the significant association of community-level factors (≥ 4 ANC visits coverage, poverty level, and maternal employment status) with EBF among infants under 6 months. It revealed approximately 9% variability in EBF across clusters. Future efforts to promote EBF should focus on older infants and communities with low poverty levels and low coverage of recommended ≥ 4 ANC visits. Furthermore, context-specific adaptation of such efforts might be required considering the variation observed between the communities in the present study.

Predictors of effective kangaroo mother care, exclusive breastfeeding, and skin-to-skin contact among low birthweight newborns in Amhara, Ethiopia.

Globally, 20% of all newborns are born with low birth weight (LBW). There is, therefore, an urgent need to expedite the delivery of high-impact, evidenced-based, and low-cost interventions such as kangaroo mother care (KMC (defined as continuous skin-to-skin care) and exclusive breastfeeding for this vulnerable group. A multinational World Health Organization (WHO)-supported consortium created and tested the impact of locally-specific and globally-informed phases of KMC care on KMC uptake/scale-up across multiple sites. Here we report on the study of KMC predictors that is nested within Amhara's KMC implementation trial in Amhara, Ethiopia. We used multivariate logistic regression phases to identify diverse predictors of KMC, skin-to-skin contact, and exclusive breastfeeding at hospital discharge and day 28 of life. We analysed data from 860 LBW newborns. At day 28, implementation period (adjusted odds ratio (aOR) = 3.2-5.0), hospital facility (aOR = 3.0-4.6), and having multiple births (aOR = 0.31) were the strongest predictors of effective KMC. Meanwhile, previous death of a newborn, type of health facility where delivery occurred, and previous LBW delivery were predictors of effective KMC at both time points. No single factor predicted KMC, skin-to-skin contact, and exclusive breastfeeding at all time points and across all implementation periods. Having multiple births was a negative predictor for skin-to-skin contact, while the implementation period and having older fathers (>29 years) were strong positive predictors for exclusive breastfeeding at both discharge and day 28. Mothers with a previous history of neonatal death and current skin-to-skin-care uptake strongly predicted exclusive breastfeeding uptake at both time points. At discharge, however, having a history of preterm birth and neonatal death strongly predicted exclusive breastfeeding uptake, while multiple current births, current very LBW newborns, and the use of standard binders decreased the likelihood of exclusive breastfeeding. To achieve the effective KMC coverage target of ≥80% in Ethiopia, KMC scale-up phases may have to consider the key predictors of KMC, EBF, and SSC to effectively target beneficiaries.

Development of the "Mother Give Me Exclusive Breastfeeding" e-booklet based on Android as a nutrition educational media

Undernutrition is one of the most serious and least addressed challenges worldwide. The significant relationship between this condition and children's feeding practices makes exclusive breastfeeding an early and appropriate intervention. Therefore, this study aimed to develop health promotion media in the form of an Android-based booklet titled "Mother Give Me Exclusive Breastfeeding".The development method model adopted was ADDIE (Analysis, Design, Development, Implementation, Evaluation). A total of 20 mothers of toddlers participated in product feasibility testing.The results showed that the product had an average total percentage of 80%, signifying high suitability for usage. The study subjects rated the E-Booklet very positively, showing great enthusiasm for engaging with the content presented in the "Mother Give Me Exclusive Breastfeeding" E-Booklet.In conclusion, further study was needed to maximize the role of this product in enhancing mothers' understanding of exclusive breastfeeding and ensuring access to facilities such as gadgets, technology devices, and internet or wifi networks.

Engaging Family Members to Support Exclusive Breastfeeding, Responsive care, and Antiretroviral Therapy Adherence Among Families with Children who are HIV-Exposed and Uninfected.

Children who are HIV-exposed and uninfected (CHEU) are at increased risk for poor growth, health, and development compared to children who are HIV-unexposed and uninfected. To support families with CHEU, we assessed the acceptability of engaging family members to support women living with HIV (WLWH) with exclusive breastfeeding (EBF) and antiretroviral therapy (ART) adherence and to engage in responsive infant caregiving. We conducted trials of improved practices, a consultative research approach, that follows participants over time as they try recommended behaviors. We enrolled postpartum women in Lusaka, Zambia, who identified home supporters. At visit 1, WLWH were interviewed about current practices. At visit 2, WLWH and home supporters received tailored EBF, responsive care, and ART adherence counseling. At visit 3, WLWH and home supporters were interviewed about their experiences trying recommended practices for 2-3 weeks. Interview transcripts were analyzed thematically. Participants included 23 WLWH, 15 male partners, and 8 female family members. WLWH reported several barriers to EBF. The most common were fear of HIV transmission via breastfeeding-despite high ART adherence-and insufficient breastmilk. After counseling, WLWH reported less fear of HIV transmission and improved breastfeeding practices. Home supporters reported providing WLWH increased support for EBF and ART adherence and practicing responsive caregiving. Both male and female home supporters appreciated being included in counseling and more involved in caregiving, and WLWH valued the increased support. Families with CHEU need focused support. Tailored counseling and family support for WLWH show promise for improving EBF, responsive caregiving, and ART adherence.

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.

Psychometric evaluation of the Indonesian version of paternal breastfeeding self-efficacy scale- short form: A confirmatory factor analysis

BackgroundFathers play a significant role in supporting sustaining exclusive breastfeeding. It is crucial to assess paternal confidence in assisting mothers during breastfeeding. Research aimThis study evaluated the psychometric properties of the Paternal Breastfeeding Self-Efficacy Scale- Short Form among Indonesian fathers. MethodsA cross-sectional study was conducted among 462 fathers whose wives gave birth to the baby in public hospitals in Indonesia. The internal consistency and test-retest reliability were examined using Cronbach's alpha and intraclass correlation coefficient. We evaluated the convergent, divergent, predictive, and construct validity. ResultsConfirmatory factor analysis demonstrated a one-factor structure model with satisfactory fit indices. The Cronbach's alpha (0.96), McDonald's Omega coefficient (0.97), and intraclass correlation coefficient (0.99) indicated an excellent reliability of the scale. The father's breastfeeding self-efficacy was positively correlated with the mother's breastfeeding self-efficacy (r= 0.251, p < .001), and negatively associated with symptoms of depression (r = -0.150, p < .01) and anxiety (r = -0.314, p < .001). We also found a positive correlation between BSES-SF and exclusive breastfeeding at two weeks postpartum (r = 0.538, p < .001). Fathers who were employed and their partner was multipara, had a vaginal birth, practiced skin-to-skin contact and rooming-in, and exclusive breastfeeding were more confident to support their partner's breastfeeding. ConclusionsThe Indonesian version of the paternal Breastfeeding Self-Efficacy Scale- Short Form is a reliable and valid tool for screening and assessing fathers’ confidence in assisting mothers in breastfeeding.

Application of longitudinal multilevel zero inflated Poisson regression in modeling of infectious diseases among infants in Ethiopia

BackgroundIn sub-Saharan African countries, preventable and manageable diseases such as diarrhea and acute respiratory infections still claim the lives of children. Hence, this study aims to estimate the rate of change in the log expected number of days a child suffers from Diarrhea (NOD) and flu/common cold (NOF) among children aged 6 to 11 months at the baseline of the study.MethodologyThis study used secondary data which exhibit a longitudinal and multilevel structure. Based on the results of exploratory analysis, a multilevel zero-inflated Poisson regression model with a rate of change in the log expected NOD and NOF described by a quadratic trend was proposed to efficiently analyze both outcomes accounting for correlation between observations and individuals through random effects. Furthermore, residual plots were used to assess the goodness of fit of the model.ResultsConsidering subject and cluster-specific random effects, the results revealed a quadratic trend in the rate of change of the log expected NOD. Initially, low dose iron Micronutrient Powder (MNP) users exhibited a higher rate of change compared to non-users, but this trend reversed over time. Similarly, the log expected NOF decreased for children who used MNP and exclusively breastfed for six months, in comparison to their counterparts. In addition, the odds of not having flu decreased with each two-week increment for MNP users, as compared to non-MNP users. Furthermore, an increase in NOD resulted in an increase in the log expected NOF. Region and exclusive breastfeeding also have a significant relationships with both NOD and NOF.ConclusionThe findings of this study underscore the importance of commencing analysis of data generated from a study with exploratory analysis. The study highlights the critical role of promoting EBF for the first six months and supporting children with additional food after six months to reduce the burden of infectious diseases.

Association between pregnancy intention and completion of newborn and infant continuum of care in Sub-Saharan Africa: systematic review and meta-analysis

BackgroundThe newborn and infant continuum of care such as essential newborn care, early initiation and exclusive breastfeeding, and immunisation are highly recommended for improving the quality of life and survival of infants. However, newborn and infant mortality remains high across Sub-Saharan African countries. While unintended pregnancies are associated with adverse newborn and infant health outcomes, there is inconclusive evidence on whether pregnancy intention influences newborn and infant continuum of care completion. Therefore, this review aimed to pool findings reported in the literature on the association between pregnancy intention and newborn and infant health care across the continuum of care in Sub-Saharan Africa.MethodsWe searched MEDLINE Complete, EMBASE, CINAHL Complete, and Global Health databases for studies potentially eligible for this systematic review and meta-analysis. Two researchers independently screened the identified articles by abstract and title, and then full-text using Covidence. We used the Newcastle–Ottawa Scale to assess the quality of the included studies. The Cochran’s Q test and I2 were executed to detect and quantify the presence of statistical heterogeneity in the studies. Meta-analysis was done for each outcome when more than one original study reported relevant data, using Stata statistical software version 18.ResultsEleven studies were included from a total of 235 articles identified by the search. The odds of completing essential newborn care (pooled odds ratio: 3.04, 95% CI: 1.56, 5.90), early initiation of breastfeeding (pooled odds ratio: 1.30, 95% CI: 1.13, 1.52), exclusive breastfeeding (pooled odds ratio: 2.21, 95% CI: 1.68, 2.89), and being fully immunised (pooled odds ratio: 2.73, 95% CI: 1.16, 6.40) were higher among infants born to women with intended pregnancies as compared to women with unintended pregnancies.ConclusionIntended pregnancy was positively associated with essential newborn care completion, early initiation and exclusive breastfeeding, and full immunisation of infants in SSA countries. Thus, policy-makers and stakeholders should strengthen the provision of quality family planning services to prevent unintended pregnancy. Furthermore, follow-up of women with unintended pregnancies is needed to increase women’s opportunity to access essential newborn health care services that further reduce the risk of newborn and infant morbidity and mortality.Systematic review registrationPROSPERO registration number CRD42023409148.

Type 2 diabetes mellitus, obesity, cesarean section delivery, and lack of exclusive breastfeeding exposure in patients from the Guadalajara Metropolitan Area, Mexico.

the combination of cesarean section delivery and limited exposure to exclusive breastfeeding (EBF) in the first six months of life may increase the risk of obesity and diabetes mellitus. This study aimed to establish an association between type 2 diabetes mellitus (T2DM) in adulthood, cesarean section delivery and incomplete breastfeeding (FBF) in individuals from the metropolitan area of Guadalajara, Mexico. this analytical cross-sectional study included patients over 18 years of age with T2DM and normal weight, overweight or obesity, regardless of sex. Informed consent was obtained. Variables encompassed T2DM, type of delivery method, first-year diet, family history, demographic, socioeconomic, and educational characteristics, and anthropometric measurements. For statistical analysis, Student's t test, chi-square tests and odds ratios were employed. the study evaluated 218 patients with an average age of 57.8 years (± 12.7) and an average age at T2DM diagnosis of 46.2 years (± 12.5). FBF (65.6 %) and partial breastfeeding (PBF) (23.8 %) prevailed in the first six months. The average age at T2DM diagnosis was 46.7 years (± 12.1) for vaginally born patients and 30.7 years (± 15.5) for cesarean-born patients (p = 0.001). Cesarean delivery increased obesity risk by nine times in patients with T2DM [OR = 8.9 (CI, 1.05, 75.2), p = 0.02]. prioritizing the limitation of nonmedically justified cesarean section deliveries is crucial to mitigate the risk of obesity and T2DM in adulthood. .

Effect of mothers‘ health literacy on early childhood allergy prevention behaviours: results from the KUNO-Kids health study

BackgroundParents can engage in several behaviours with regard to early childhood allergy prevention (ECAP). These can be related to diet of mother/child and the modification of the home environment; not all of them are justified by current evidence. Previous studies showed that parental health literacy (HL) is related to favourable health behaviours directed at the child. This study aimed to investigate the causal effect of mothers’ HL on ECAP behaviours and to test different moderators of this effect.MethodsOne thousand six hundred sixty-two mothers participating in the KUNO-Kids health study in the area of Regensburg, Germany were surveyed on HL (assessed via the health care scale of the Health Literacy Survey-EU questionnaire, HLS-EU-Q47) and ECAP behaviours implemented during pregnancy and the child’s first year of life. Patterns in ECAP behaviours were identified by latent class analysis. Multinomial regression modelling was performed with HL as exposure, ECAP as outcome variable, allergy risk, parental competence and bonding, anxiety and depression as moderators as well as potentially confounding variables.ResultsWe identified three classes of ECAP behaviours (class 1: „breastfeeding “ N = 871; class 2: „allergen-avoidance “ N = 490; class 3: „mixed behaviours “ N = 301). In univariable as well as fully adjusted regression models, compared to class 1, class 2 was negatively, and class 3 was not associated with HL. None of the tested moderating variables altered the association between HL and ECAP significantly.ConclusionsWe found an effect of mothers’ HL on ECAP behaviours: lower HL of mothers increased allergen-avoiding behaviour directed at their child, while decreasing the chance of exclusive breastfeeding. Improving HL could contribute to the implementation of recommended ECAP behaviours in families, especially to the reduction of allergen-avoiding behaviours.

Exclusive breastfeeding and its association with pre- and postnatal factors

Exclusive breastfeeding and its association with pre- and postnatal factors

Overview of Organizational Factors on Cadre Performance in the Implementation of Posyandu Toddler

Cadres at Sucopangepok village play a crucial role in reducing stunting by educating about essential practices for toddlers, such as exclusive breastfeeding, proper complementary feeding, and maintaining hygiene to ensure adequate nutrition and prevent infections. The cadres offer health nutrition education to pregnant women and parents of toddlers by monitoring their growth at the posyandu, helping to detect stunting early. They serve as the primary line of defense in improving public health, as they understand their community's characteristics. This study aimed to describe organizational factors on performance in implementing posyandu for toddlers. This study used descriptive research to describe organizational factors including infrastructure, rewards, job design, and leadership on cadre performance. Involved 45 cadres as respondents taken by total sampling. Data was collected using interviews questionnaires, observation, and documentation, then the data was analyzed using descriptive data analysis which will describe the characteristics of each. Facilities infrastructure and work design have good results even though in the facilities and infrastructure, there are facilities that need to be replaced and repaired. The rewards in the category are inappropriate. Leadership is in the adequate category due to the lack of closeness between the leader and the cadres. Cadre's performance during toddler posyandu activities showed promising results. The description of organizational factors in facilities and infrastructure and job design is good, rewards in the category are inappropriate, and leadership is in the adequate category with good cadre performance.

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.