Exclusive Breastfeeding Of Infants Research Articles

Differences in the Fecal Metabolome and Microbiome Between Exclusive and Partial Breastfed Infants are More Pronounced at 2 Months Compared to 5 Months

Abstract Objectives This study aimed to characterize the impact of feeding practices on the infant fecal metabolome and microbiome at 2 months and 5 months of age in exclusive breastfeeding (EBF) and partial breastfeeding (PBF) infants. Methods Fecal samples were collected from infants at 2 months and 5 months of age from Bandung, Indonesia. Exclusive breastfeeding was determined using the stable isotope deuterium dose-to-mother (DTM) technique. Fecal metabolites were extracted using Dulbecco's phosphate-buffered saline, and analyzed using NMR spectroscopy. Fecal microbial DNA was extracted at the same time using the MoBio PowerLyzer PowerSoil DNA isolation kit (MoBio, Carlsbad, CA). The V4 region of 16SrRNA was targeted. The DNA library sample was analyzed via 300-bp paired-end sequencing on the Illumina MiSeq platform. Results Fecal samples from EBF infants at 2 months of age revealed significantly higher human milk oligosaccharides (HMOs), short-chain fatty acids and related metabolites compared to PBF infants. However, fecal samples from infants at 5 months of age revealed no differences in metabolome between EBF and PBF after p-value adjustment for multiple comparisons. Gut microbes, especially Bifidobacterium were higher in EBF infants at age 2 months even though not statistically significant. However, this difference was eliminated at age 5 months. Conclusions In the present study, infant feeding practices had a stronger influence on the infant fecal metabolome and microbiome at the age of 2 months as compared to 5 months. Funding Sources 2014 Bill & Melinda Gates Foundation. CS would also like to acknowledge funding from the Kinsella endowed chair in Food, Nutrition, and health as well as USDA-NIFA Hatch project 1,021,411.

Maternal Adherence to a Dairy-free Mediterranean Diet and Symptoms of Colic and Allergy in Exclusively Breastfed Infants: A Randomized-Controlled Study

Abstract Objectives Colic and allergy symptoms are problems encountered in the exclusively-breastfed newborn and are thought to be triggered by inflammatory responses in the gut. Maternal diet, especially cow's milk intake, has been associated with infantile colic and allergies, but no study examined the effect of Mediterranean diet. Thus, this study aims to investigate whether maternal adherence to a dairy-free Mediterranean diet, known for is anti-inflammatory properties, reduces colic and allergy symptoms in exclusively-breastfed infants. Methods Exclusively breastfeeding healthy primiparous women were recruited during their pregnancy third trimester and were randomly assigned to receive an education on dairy-free Mediterranean diet or no education (control group). Mother-infant pairs were followed up for 2 months postpartum and adherence to the diet was confirmed through 24 hour recalls. Data on infant fussing & crying using validated “Daily Crying Diary” (Barr, et al., 1988) and allergy symptoms using validated CDC's “Breastfeeding and Infant Feeding Practices postnatal questionnaire” (Centers for Disease Control and Prevention, 2017) were collected on weeks 2, 4 and 7 postpartum. Infant stool samples were also collected to test for blood, pH, and eosinophil cationic protein as estimates of the degree of inflammation in the gut. Results Preliminary data from 10 mother-infant pairs showed that there was no group differences in the weights of the mothers and infants and number of allergy symptoms throughout the study. Colic (defined by the “Wessel Criteria” as crying episodes that last for >3 hours per day, for ≥3 days per week and for ≥3 weeks) was not observed in any infant. Findings from “Daily Crying Diaries” revealed that maternal adherence to dairy-free Mediterranean diet was associated with significantly lower average daily crying compared to controls (0.28 vs. 1.10 hours/d) in infants. Results on infant stool blood, pH, and eosinophil cationic protein are still pending. Conclusions Maternal adherence to a dairy-free Mediterranean diet did not affect allergy symptoms but decreased fussing and crying in exclusively breastfed infants. Mechanisms of action still remain to be determined. Funding Sources Lebanese American University.

Examination of Carbohydrate Products in Feces Reveals Potential Biomarkers Distinguishing Exclusive and Nonexclusive Breastfeeding Practices in Infants

ABSTRACTBackgroundThe stable isotope deuterium dose-to-mother (DTM) technique to estimate nonbreast milk water intake demonstrates that maternal self-report methods of infant feeding overestimate the true prevalence of exclusively breastfeeding practices.ObjectiveWe aimed to determine potential monosaccharide and oligosaccharide markers that distinguish between exclusively breastfed (EBF) versus nonexclusively breastfed (non-EBF) infants utilizing LC-MS-based methods.MethodsData for the analysis were collected as part of a larger, longitudinal study of 192 breastfed Indonesian infants aged 2 mo and followed up at 5 mo. Feces samples were collected from infants aged 2 mo (n = 188) and 5 mo (n = 184). EBF and non-EBF strata at each time point were determined via the DTM technique. Feces samples were analyzed to determine monosaccharide content using ultra-high-performance LC-triple quadrupole MS (UHPLC-QqQ MS). Relative abundances of fecal oligosaccharides were determined using nano-LC-Chip-quadrupole time-of-flight MS (nano-LC-Chip-Q-ToF MS).ResultsAt age 2 mo, monosaccharide analysis showed the abundance of fructose and mannose were significantly higher (+377% and +388%, respectively) in non-EBF compared with EBF infants (P <0.0001). Fructose and mannose also showed good discrimination with areas under the curve (AUC) of 0.86 and 0.82, respectively. Oligosaccharide analysis showed that a 6-hexose (Hex6) isomer had good discrimination (AUC = 0.80) between EBF and non-EBF groups at 5 mo.ConclusionCarbohydrate products, particularly fecal mono- and oligosaccharides, differed between EBF and non-EBF infants aged under 6 mo and can be used as potential biomarkers to distinguish EBF versus non-EBF feeding practices.

HUBUNGAN PEMBERIAN MP-ASI DINI PADA BAYI DENGAN PENGETAHUAN, SIKAP IBU DAN DUKUNGAN KELUARGA DI KLINIK PRATAMA ROSNI ALIZAR MEDAN

Abstract&#x0D; Introduction: Complementary Food for Early Breast Milk (MP-ASI) is a condition where infants aged 0-6 months are not only given breast milk, but are given additional fluids such as formula milk, oranges, honey, tea and solid foods such as bananas, milk porridge, biscuits, rice porridge, and team rice.Objective: This study was to determine the relationship of knowledge, attitudes, and family support with the provision of early breastfeeding for infants at the Pratama Rosni Alizar Clinic in Medan in 2019. Method: Design this study used an analytical survey with cross sectional approach. The population in this study were all mothers who have babies aged 0-6 months, as many as 30 people. Sampling using total population, that is, the entire&#x0D; &#x0D; population is sampled. Retrieval of data using primary data using Chi-square test at a 95% confidence level. Results and Conclusions: Based on the research showing that there is a relationship between maternal knowledge and the provision of early MP-ASI in infants with the acquisition of p value = 0.027 (&lt;0.05), there is a relationship between maternal attitudes and the provision of early MP-ASI in infants with the acquisition of p value = 0.004 (&lt;0.05), and there is a relationship of family support with early breastfeeding for infants with the acquisition of p value = 0.042 (&lt;0.05).Suggestion:Health workers are expected to provide information and counseling on exclusive breastfeeding for infants up to 6 months of age without providing any additional food.&#x0D; &#x0D; Keywords : Knowledge, Attitude, Family Support, Early MP-ASI

Knowledge, Attitude and Practices of Mothers Regarding Exclusive Breastfeeding in Infants Admitted in PIMS, Islamabad

Knowledge, Attitude and Practices of Mothers Regarding Exclusive Breastfeeding in Infants Admitted in PIMS, Islamabad

Prevalence and Predictors of Exclusive Breastfeeding among Mothers with Term Deliveries in Adventist Medical Center Manila (AMCM) Immediately Postpartum and at One Month Postpartum

Exclusive breastfeeding in infants provides an optimal nutrition in infants aged under six months. While the World Health Organization (WHO) recommends to exclusively breastfeed their infants even up to 2 years, prevalence and duration of breastfeeding among different countries are declining. The aim of this study is to compare the prevalence of exclusive breastfeeding immediately postpartum and one month postpartum and determine its associated factors and possible predictors in Adventist Medical Center Manila (AMCM). A total of 235 mothers who delivered in the hospital were interviewed using a questionnaire prior to discharge and was followed-up via telephone call at one month postpartum. All analyses were carried out using Statistical Package for the Social Sciences (SPSS) Version 21. All inferential analyses were performed at 5% level of significance, but the interpretation of the multiple binary logistic regression analysis at 10% level of significance and its implications was also considered. The prevalence of exclusive breastfeeding significantly decreased from 100% immediately postpartum to 74% at 1 month postpartum (p&lt;0.001). Among the possible associated factors, at 10% level of significance, 3 factors were considered as independent predictors of exclusive breastfeeding at 1 month postpartum namely: previous breastfeeding experience (OR = 3.70, p = 0.080) presence of lactation area at work (OR = 2.08, p = 0.087) and presence of refrigerator at work for breast milk storage (OR = 2.98, p = 0.057) [1-3]

Epidemiology of non-exclusive breastfeeding behavior (study in the working area of primary health care Margorejo Pati regency)

Non-exclusive breastfeeding is defined as the provision of food or fluids in addition to drugs, vitamins, and minerals to infants before the age of 6 months. Exclusive breastfeeding for infants is seen to prevent and cure stunting and other forms of malnutrition. Primary Health Care (PHC) Margorejo is the health center with the lowest exclusive breastfeeding coverage in Pati Regency in 2017 and 2018. The purpose of this study was to analyze the factors related to the behavior of non-exclusive breastfeeding in the working area of the PHC Margorejo in Pati Regency. This study uses a case control method. The research sample consisted of 70 consisting of 35 cases and 35 controls. The research targets were mothers who have 6-11 months old infants in the working area of the PHC Margorejo. Bivariate analysis showed a low level of maternal knowledge (p = 0.008), negative maternal attitudes (p = 0.022), and the absence of support from health workers (p = 0.002) related to non-exclusive breastfeeding behavior. Low level knowledge of mothers, negative attitude of mothers, and the absence of support from health workers are all factors related to the behavior of non-exclusive breastfeeding in the working area of PHC Margorejo in Pati Regency.

Factors Affecting Exclusive Breastfeeding Practice using Social Cognitive Theory Constructs: A Multilevel Evidence from Madiun, East Java

Background: Exclusive breastfeeding for infants up to 6 months of age is the most effective way to ensure the health and the viability of the child. Exclusive breastfeeding coverage still does not meet the target due to various factors. This study aimed to determine the effectiveness level of health promotion of exclusive breastfeeding program in the integrated health service in Madiun, East Java. Subjects and Method: This was an a cross-sectional study conducted in Madiun, East Java, from February to May 2020. A sample of 200 lactating mother who had infants aged 6 to 24 months was selected randomly. The dependent variable was exclusive breastfeeding practice. The independent variables were health promotion program, observational learning, role model, vicarious learning, imitation, attitude, outcome expectation, self regulation, self-efficacy, rein­forcement, and integrated health post contextual. The data were collected using questionnaire and analyzed by a multilevel multiple logistic regression run on Stata 13. Results: Exclusive breastfeeding practice increased with adequate health pro­motion program (OR= 3.08; 95% CI= 1.06 to 8.94; p= 0.038), high observational learning (OR= 3.86; 95% CI= 1.31 to 11.39; p= 0.014), strong role model (OR= 4.01; 95% CI= 1.12 to 14.29; p= 0.033), vicarious learning (OR= 4.46; 95% CI= 1.34 to 14.82; p= 0.015), strong imitation (OR= 2.74; 95% CI= 1.02 to 7.35; p= 0.045), positive attitude (OR= 3.51; 95% CI= 1.04 to 11.88; p= 0.043), positive outcome expectation (OR= 4.04; 95% CI= 1.32 to 12.38; p= 0.014), strong self-regulation (OR= 2.36; 95% CI= 0.93 to 5.99; p= 0.068), strong self-efficacy (OR= 5.35; 95% CI= 1.81 to 15.77; p= 0.002), and strong reinforce­ment (OR= 3.90; 95% CI= 1.21 to 12.57; p= 0.022). There was a contextual effect of inte­grated health post on exclusive breastfeeding practice with intraclass correlation (ICC)= 10.97%. Conclusion: Exclusive breastfeeding practice is affected by health promotion program, obser­vational learning, role model, vicarious learning, imitation, attitude, outcome expectation, self regulation, self-efficacy, and reinforcement. Integrated health post has a contextual effect on exclusive breastfeeding practice. Keywords: exclusive breastfeeding, health promotion, social cognitive theory. Correspondence: Rezyana Budi Syahputri. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta 57126, Central Java, Indonesia. Email: rezyanabs@gmail.com. Mobile: +6282325750134. Journal of Health Promotion and Behavior (2020), 05(03): 169-173 https://doi.org/10.26911/thejhpb.2020.05.03.03

Breast Feeding Remains a Strong Protection against Infant Infections.

Background: Breast feeding prevents infections in infants. Those who are partially or never breast-fed and receiving bottle feeds are at higher risk of infections as compared to exclusive breast-fed infants. The objectives of this study were to record the effect of exclusive breast feeding versus partial and never breast feeding on infections in infants and also to find an association of infection with type of feed, gestation and vaccination status in infants till six months of age.Material and Methods: A total of 500 Infants were included in this cross-sectional study. Information regarding pattern of feeding and infections was obtained by verbal interview of mother and the questionnaire was filled by the study physician. The outcome evaluated was infections in infants till one year of age. Categorical comparisons were made using chi square test. A ‘p’ value &lt; 0.05 was considered statistically significant.Results: Out of 500 infants, 59.4% were males. About 59.6% were exclusively breast-fed till 6 months of age, 31.2% were partially breast-fed and 9.2% were never breast-fed. In exclusively breast-fed group, 29.5% infants reported infections as compared to 40.4% in partial breast-fed group and 65.2% in never breast-fed infants (P &lt; 0.000). Similarly, 40.6% of infants in exclusively breast-fed group, 55.1% in partial breast feed and 58.7% in the never breast-fed reported infections in 4-6 months of age, which was statistically significant (P = 0.003). There was no significant difference in infection rates among the three study groups in 7-9 (P=0.192) and 10 -12 months (P=0.42) of age.Conclusions: Exclusive breast feeding till six months of age significantly reduces the risk of infections in infancy.

Changes in rates of early exclusive breast feeding in South Africa from 2010 to 2013: data from three national surveys before and during implementation of a change in national breastfeeding policy

ObjectiveBetween 1998 and 2009 reported exclusive breastfeeding (EBF) rates in South African infants, aged 0–6 months, ranged from 6.2% to 25.7%. In 2011, the National Minister of Health shifted policy...

Factors associated with exclusive breast-feeding: A cross-sectional survey in Kaiyuan, Yunnan, Southwest China.

Breastfeeding has a wide range of benefits for both infants and mothers. The identification of factors associated with exclusive breastfeeding (EBF) are important to increase the prevalence of EBF. The study aimed to determine the prevalence of EBF within the first six months and its associated factors in Kaiyuan, Yunnan Province, Southwest China. This cross-sectional study was conducted in Kaiyuan, a middle-sized city of Yunnan Province, Southwest China. Mothers of infants under twelve months were randomly selected for a face to face interview in four towns (two in urban areas and two in rural areas) in Kaiyuan. A structured questionnaire was applied for collection of sociodemographic information, mothers’ and infants’ health, and breastfeeding information. A 24-hour food recall survey was used to collect infant feeding information. A logistic regression analysis was performed to identify the factors independently associated with exclusive breastfeeding for infants up to six months of age. The number of 417 mothers with infants under six months was interviewed. The prevalence of EBF at six months was 27.34%. Logistic regression indicated that EBF within six months was more likely to be practiced by mothers who had higher average household income per year (OR = 2.09, 95% CI: 1.05–4.17 p = 0.037; OR = 1.85, 95% CI: 1.04–3.28 p = 0.037), and mothers who received breastfeeding information (OR = 2.46, (95%CI: 1.45–4.18, p = 0.0009). The prevalence of EBF in Kaiyuan, Southwest China is considerably lower than national and international recommendations. Yearly household income, and mothers who received breastfeeding information are associated with higher EBF prevalence. Breastfeeding information should be given to mothers in order to increase the prevalence of EBF.

Exclusive breast-feeding is associated with reduced pacifier sucking in children: Breast-feeding and pacifier-sucking habit

BackgroundStudies suggest that when children do not achieve the emotional satiety and adequate stimulus provided by breast-feeding, they exhibit sucking behaviors. This study aimed to estimate the association from 4 through 6 months of exclusive breast-feeding (EB) postpartum and pacifier-sucking behavior at 12 months of life. MethodsA cohort study was conducted with 1,037 infants, born alive and monitored up to 12 months. At 4 and 6 months after birth, the children were classified according to the type of breast-feeding they had received: exclusive, predominant, complementary, or none. The prevalence of pacifier-sucking behavior was calculated, and the association between the 2 events was estimated. Mothers’ socioeconomic-demographic characteristics, delivery features, and prenatal care, as well as the biological characteristics of the children, were determined. Relative risk (RR) and 95% confidence intervals (95% CI) were calculated. ResultsIn comparison with EB infants, the RR of pacifier-sucking behavior at 12 months of life was higher in children receiving complementary breast-feeding or no breast-feeding for both 4 months (RRadjusted, 1.68 [95% CI, 1.39 to 2.02] and RRadjusted, 2.67 [95% CI, 2.24 to 3.17], respectively) and 6 months (RRadjusted, 1.43 [95% CI, 1.03 to 2.00] and RRadjusted, 3.30 [95% CI, 2.40 to 4.54], respectively). Conclusions and Practical ImplicationsEB for 6 months postpartum is associated with reduced pacifier-sucking behavior, adjusted for maternal color, number of prenatal consultations, and family income. Promotion of EB may reduce the use of pacifiers and their potential deleterious effects on oral health. Dental health care professionals should consider discussing the importance of breast-feeding with their patients with regard to the possible development of sucking habits in their children.

Discontinuation of Exclusive Breastfeeding in Ghana: A Longitudinal, One-Group Observational Study of Postnatal Mothers With Children 0-6 Months old.

Although exclusive breastfeeding of infants has several benefits, in Ghana only 52% of children under 6 months old are breastfed exclusively. However, researchers have not conducted longitudinal observational studies to examine exclusive breastfeeding discontinuation and determine risk factors. (1) To determine exclusive breastfeeding discontinuation, and (2) to examine those factors linked to discontinued exclusive breastfeeding. A longitudinal, one-group observational study was conducted. A total of 322 mothers who had normal and full-term delivery at a district level referral hospital from January to December 2017 were recruited, followed-up every month, and subsequently interviewed after 6 months postpartum. Data were collected using validated questionnaires. Binary and multivariable Poisson regression analyses were the statistical analytical methods used. Respondents' mean age was 29.78 years (SD = 5.20). Among the 322 mothers who initiated breastfeeding with human milk at birth, 108 (34%) discontinued exclusive breastfeeding before 6 months postpartum. After controlling for possible covariates, attending antenatal care 4 or less times during pregnancy (aRR = 6.54; 95% CI [1.77-24.22]; p = .005); lack of support from family to breastfeed exclusively (aRR = 2.41; 95% CI [1.23-4.71]; p = .010), outside pressure to provide other food to the baby < 6 months postpartum (aRR = 1.87; 95% CI [1.01-3.46]; p = .045), and living in an urban area (aRR = 2.10; 95% CI [1.17-3.75]; p = .013) significantly increased the risks of discontinuing exclusive breastfeeding. Universal exclusive breastfeeding may not be achieved without tackling the key determinants of discontinuation of exclusive breastfeeding. Health facility and community-based exclusive breastfeeding promotion interventions are therefore needed.

Prevalence and Maternal Concerns of Exclusive Breast Feeding in Libyan Women in Albaida City

Exclusive breastfeeding (EBF) is strongly recommended by the World Health Organization, United Nation Children's Fund (UNICEF), and American Academy of Pediatrics during the first six months of life. Breastfeeding should continue up to two years for optimal growth and development while it is suggested to start supplementary foods beginning from the seventh month. The study aimed to determine the frequency and examine the affecting factors of EBF in infants who attended the pediatrics outpatient clinic in Althawra Hospital in Albaida city, Libya. A cross-sectional study was conducted in eight months period among 223 breastfeeding mothers, with infants aged 6-24 months, who attended the pediatrics Outpatient clinic. Mothers’ perceptions about breastfeeding, complementary feeding practices, and demographic characteristics were collected by interviews with them. EBF periods were 1-45 weeks, Median week was 17 weeks. Six months EBF rate was 32,28%. Younger mother (≤ 20) or older (≥35) ages, and mothers having chronic diseases had a shorter median week of EBF. The median duration of breastfeeding was 9 months (0-24 months). The most frequent reason of the early interruption of EBF was, according to mother’s perceptions, for having inadequate breast milk (50.3 %). The study indicates that the frequency of 6 months EBF (32,28%) and the median duration of breastfeeding (17 weeks) are low in Albaida. A local strategy must be developed to overcome mothers negative perceptions about EBF in the first 6 months of age.

Assessment of Human Milk Intake by Breastfed Infants Using Deuterium Oxide Dose-to-Mother Technique in “Tumbuh Kembang Anak” Cohort, Indonesia

Indonesia government has done the WHO recomendation that the infants should be exclusively breastfed for the first six months of life to achieve optimum growth, development and health. Nevertheless, the percentage of exclusive breastfed infants have not achieved the target yet and has not been scientifically quantified. The objective of the study i s to measure the intake of human milk of Indonesian infants during first 6 months and to record the breastfeeding practices of mothers. Thirty healthy mother-infant pairs were recruited randomly for the cross-sectional study at “ Tumbuh Kembang Anak ” cohort in Bogor. Milk intake to the infant was measured using the deuterium oxide technique over 14 days. The interviews were done by members of team using the questionnaire to get the information on breastfeeding practice of respondents. The results showed that i ntake of human milk was 784 ± 117g.d -1 (mean ± SD), 787 ± 180 g.d -1 for infants 3 and 6 moths of age. It showed that the milk intake were not different between 3 and 6 months. The body composition of mothers, age, or parityhad no effects on milk intake of infants, education of mothers (3 months aged, P = 0.061, r = -0.097 and 6 months, P = 0.616, r = -0.095), infants of 3 months aged, P = 0.200, r = -0.290 and 6 months, P = -0.078, r = 0.684). Body mass index of mother (P &lt; 0.05, r = 0.963) were correlated with the milk intake. About 53 % of the lactating mothers started breastfeeding within less than one hour of delivery. Breast-milk intake of the Indonesian infants were documented using deuterium oxide-to-the-mother technique. In the current study concluded that the exclusive breastfeeding practices with 30 pairs of mother-infant still shows that the conditions of exclusive breastfeeding practices have not been properly adhered to by mothers who deliver babies. It is recommended that "mother and baby health officer" in Indonesia are increasingly promoting in order mothers in urban and rural areas to breastfeed exclusively for up to 6 months

Trend of Breastfeeding and its Impact on Morbidity in Children in a Tertiary Care Hospital in Kathmandu

Introduction: WHO advocates for exclusive breastfeeding in infants till six months of age. Exclusive breastfeeding has been estimated to reduce 70% of infection related mortality in children. This study aims to elaborate the current trend of breastfeeding and its impact on common infectious morbidities in children.&#x0D; Methods: This study was a prospective longitudinal study done at Kathmandu Medical College Teaching Hospital with a sample size of 103 infants. Detailed proforma including sociodemographic data, breastfeeding related data and morbidities were collected at one and half months of life. The patients were followed up at 6 months of age again and the same proforma was again filled up. Statistical analysis was done with SPSS 20.0 and various associations were elucidated. &#x0D; Results: A total of 103 infants were analyzed. Males were 58 in numbers with mean birth weight of the infants being 3048±537 grams. Breast feeding was initiated within an hour in around 37%. At one and half months of age, 63% reported of exclusive breastfeeding which decreased to 23% at 6 months of age. Breastfeeding for at least 45 days decreased the incidence of Acute Respiratory Infections(ARI), Acute Otitis Media(AOM) and diarrheal diseases although statistically significant difference was found with only ARIs. &#x0D; Conclusion: Prevalence of exclusive breastfeeding is low in the study. The study has also shown that breastfeeding significantly reduces incidence of common infectious morbidities in infants.

Prevalence of exclusive breastfeeding and associated factors among refugees from Palestine in Jordan: a cross-sectional study

BackgroundWHO and UNICEF recommend early initiation of breastfeeding, within the first hour after delivery, and exclusive breastfeeding (EBF) in the first 6 months of infant life. The most recent data available (from 2001) show that the EBF prevalence among Palestinian refugee infants under 4 months in Jordan was 24%. The study objectives were to estimate the current prevalence of EBF and early initiation, and to examine factors associated with EBF among refugees from Palestine in Jordan registered with UNRWA. MethodsA cross-sectional facility-based study was conducted between April and June, 2017, in all areas of operation of UNRWA in Jordan; North Amman, South Amman, Irbid, and Zarqa. The study targeted Palestinian refugee mothers of children under 6 months of age surveyed at five UNRWA health centres. One health centre was randomly selected from each area (but two from Zarqa) with proportionate probability, excluding those for which there were problems of accessibility. All eligible mothers who attended maternal and child health services on the day of the survey and agreed to participate were recruited, and the process repeated until the required number of participants was achieved. A structured questionnaire was used to collect data. We used the WHO definition of EBF to measure the proportion of infants under 6 months of age that were breastfed exclusively in the previous 24 hours. Bivariate and multivariate logistic regression analysis were employed to identify the independent predictors of EBF. The study protocol was approved by UNRWA and Nagasaki University. Informed written consent was obtained from each participant prior to the interview. FindingsA total of 307 participants (mean age, 27·4 years; range 17–45) were included in the analysis. Nearly one third (31%; 95 out of 307) lived in a refugee camp. The prevalence of EBF in infants under 6 months was 34% (105 out of 307; 95% CI 29–40), and 49% (148 out of 307; 95% CI 43–54) of mothers started breastfeeding within 1 hour after delivery. The rate of EBF was significantly higher in younger infants. Multiparous mothers (adjusted odds ratio 2·38; 95% CI 1·23–4·59) and mothers who did not have problems with breastfeeding (2·12; 95% CI, 1·25–3·57) were more likely to breastfeed exclusively. InterpretationThe prevalence of EBF has improved since 2001, but is still below the WHO recommendation of 50%. Providing adequate support, especially to first-time mothers, mothers who have problems (eg, difficulty in latching on and mastitis), and mothers of older infants, may be a feasible strategy to improve the prevalence of EBF among refugees from Palestine in Jordan. FundingJointly funded by Nagasaki University and UNRWA.

Association between ankyloglossia and breastfeeding.

To analyze the association between ankyloglossia and breastfeeding. A cross-sectional study was undertaken on 130 newborn infants in exclusive breastfeeding with Apgar score ≥ 8 within the first five days of life. The research was approved by the Ethics Committee on Human Research. The data collection was performed by the researcher and by three trained speech therapists of the team. The protocols applied were the Neonatal Tongue Screening Test from the Lingual Frenulum Protocol for Infants, the UNICEF Breastfeeding Observation Aid, and the collection of maternal complaints related to the difficulty in breastfeeding was also considered. The data were submitted to statistical analysis - chi-square test and Fisher's exact test, with a significance level of 5%. When correlating the data, the statistical analysis revealed an association between ankyloglossia and the items of suckling category of the Breastfeeding Observation Aid. The association between complaint of difficulty in breastfeeding and ankyloglossia was also seen. On the first days of life, ankyloglossia is associated with the mother's breastfeeding complaint and with the newborn's sucking difficulty.

Effect of Nutrition Education Among Fathers on Exclusive Breastfeeding of Infants in Kisumu County, Kenya

: Breastfeeding is essential for infants providing them the much-needed nutrients for a health start. The World Health Organization recommends exclusive breastfeeding for the first six months of the infant’s life. The objective of this study was to assess the influence of nutritional education among fathers on exclusive breastfeeding practices for infants aged 0-6 months in Kisumu County, Kenya. An interventional study was conducted. The study setting was Kisumu East Sub County, Kenya. A total of 290 father-mother pairs were recruited into the study. Recruitment took place at Kisumu County hospital when the mothers were at 23-27 weeks gestational age. Pairs were randomized into either intervention or control group with 145 pairs per group. Pairs in the intervention group received nutrition education on breastfeeding (exclusive breastfeeding and male involvement), while those in the control group did not receive any intervention during the one-year research period. Quantitative data on exclusive breastfeeding practice, maternal and paternal knowledge and support towards breastfeeding were collected using an interviewer administered pretested questionnaire, while qualitative data were collected through 4 focus group discussions in both intervention and control groups. The proportion of infants fed only mother’s milk at 6 months was significantly higher (77.7 %) in the intervention group than in the control group (45.1%, p&lt;0.001). Fathers in the intervention group who had been exposed to nutrition education on breastfeeding and were knowledgeable on exclusive breastfeeding were twice more likely to exclusively breastfeed. Nutrition education to fathers on breastfeeding impacts positively on breastfeeding rates.

FACTORS AFFECTING THE SUCCESS OF EXCLUSIVE BREASTFEEDING AMONG BREASTFEEDING MOTHERS IN CHILD’S POLY OF DKT GUBENG POJOK HOSPITAL, SURABAYA

Background. The survival of children to grow and develop and get good care is needed to achieve a healthy generation. The success of exclusive breastfeeding in infants 0-6 months in Indonesia still does not meet expectations due to a poor knowledge of the importance Exclusive Breastfeeding and their perception of infant formula is better than breast milk. The low achievement of breastfeeding (ASI) exclusively due to several factors, namely low knowledge of the mother of the importance of breastfeeding, the sex of the baby, birth weight or premature birth, culture that does not support, families that do not support, and social change that happening in the community.Objective. This study aimed to examine predictive factors toward the success of exclusive breastfeeding among breastfeeding mothers in Child’s Poly DKT Gubeng Pojok Hospital, Surabaya.Methods. The design of this study is a cross-sectional study. The variables studied were age, occupation, level of education, family support, and exclusive breastfeeding success. The results of this study were analyzed using the Stepwise Multiple Regression method with SPSS 21.Result. Family support (β = 0.78, p &lt; .001) were significant predictor of exclusive breastfeeding success and accounted 75.9% in the variance of exclusive breastfeeding success (R2 = .759, F (4, 27) = 9.18, p &lt; .001).Conclusion. The importance of family support in supporting the success of exclusive breastfeeding in infants 0-6 months. For this reason, health workers are expected to improve their approach to families so that they want to provide support to breastfeeding mothers. Keywords: Exclusive breastfeeding, infants 0-6 months, factors affecting, breastfeeding mothers