Exclusive Breastfeeding Research Articles

Penerapan Pemberian Asi Eksklusif dan MP-ASI Pada Pertumbuhan Balita di Desa Sidomulyo Kecamatan Biru-Biru Kabupaten Deli Serdang

The growth and development of babies is mainly influenced by the nutrients contained in breast milk, which include proteins, carbohydrates, minerals and vitamins which are important for health and growth. Entering the age of 6-24 months, toddlers' energy needs increase and require additional nutritional support through providing appropriate complementary foods (MP-ASI) to encourage optimal growth and development. The purpose of this public work is to secure exceptional breastfeeding and MP-ASI education in the growth of babies in the village of Sidomulyo and Deliserdang regency. This counseling is given to Mothers with children aged 0 to 5 years. Thirty-two mothers and toddlers participated in this outreach activity. It is hoped that this counseling can provide parents with an understanding of the importance of exclusive breastfeeding and how to provide MPASI appropriately to prevent the risk of malnutrition and stunting.

The incidence of stunting based on gender in Indonesia: A literature review

Background: Stunting is a chronic malnutrition issue caused by insufficient nutritional intake over a prolonged period, resulting in growth disturbances in children, such as a height that is shorter than the standard for their age. Stunting is always preceded by weight faltering, which refers to inadequate weight gain when compared to the standard weight gain for age and sex. Other factors associated with the occurrence of stunting include exclusive breastfeeding, the age at which complementary feeding (MP-ASI) is introduced, the child’s age, parenting practices, and gender. One study indicates that in Indonesia, boys are at a much higher risk of stunting than girls. Another study states that it is difficult to draw conclusions about whether girls or boys are more at risk of stunting, as the prevalence of stunting is equally high in both genders. This difference in opinions is what led the author to be interested in conducting this research. Objective: The aim of this study is to understand why gender is associated with the occurrence of stunting. Method: The results of this literature review are based on observations from various journals that meet the inclusion criteria. Conclusion: Based on the results observed, it was concluded that boys are more likely to experience stunting than girls.

HUBUNGAN ANTARA ASI EKSKLUSIF DENGAN PERKEMBANGAN BAYI USIA 6-12 BULAN

Child’s development in the early of life will effect children wellbeing in the future. Early child development will be optimal if their nutritional need has been fullfiled. Breast Milk is the best food for baby in their early life. The purpose of this research was to know the association between duration of breast feeding with baby development age 6-12th month in Puskesmas Jambon work area district Ponorogo. This study was quantitative researches with cross sectional design which was done to 141 baby age 6-12th month in Puskesmas jambon work area. The result of this study was 47,5% baby who was not receiving exclusive breast feeding suspected had delayed developmental status, 26,2% baby who had been exclusively breast feeding for 6 month suspected had delayed developmental. Statistical analyze with logistic regression showed there are positif correlation between nutrional status with baby’s development p=0,020. Baby who was not exclusively breast feeding until 6-month 2,5 time higher to have delayed development (95% CI 1,158-5,308).

Development of a Local Food-Based MPASI Kitchen Integrated with the Golden1000 Application to Enhance Skills of Cadres and Mothers of Infants Aged 6-12 Months in Stunting Prevention

Background : Bungursari Health Center led stunting cases in Tasikmalaya City in 2022 due to low exclusive breastfeeding rates and poor complementary feeding practices. This study addressed these issues through PMBA training, the Golden1000 app, and posyandu kitchen development. Contribution : PMBA training improved knowledge and skills in baby food preparation, promoted the Golden1000 app for 1000 HPK education, and fostered entrepreneurial posyandu kitchens. Metode : Training covered complementary food preparation, Golden1000 app use, and posyandu kitchen development. Results : The training and Golden1000 app usage improved knowledge and skills, leading to the formation of a posyandu kitchen. Conclusion : The program enhanced complementary food preparation skills and established a lasting posyandu kitchen initiative.

Decadal trends in the exclusive breastfeeding practices among working Indian mothers: a multi-level analysis

BackgroundExclusive breastfeeding (EBF) is defined as feeding infants only breast milk of the mother or a wet nurse for the first six months, without additional food or liquids except the oral rehydration solution or drops/syrups of vitamins, minerals or medicines. The working status of women in developed countries adversely affects the EBF rates, which calls for an assessment in rapidly developing countries like India. Therefore, the primary aim of the present study is to determine the prevalence of EBF using the data from the National Family Health Surveys (NFHS 3, 4, 5) conducted between 2005 and 06, 2015-16 and 2019-21 to estimate the likelihood EBF according to mothers’ employment status.MethodsWe did a secondary data analysis of the cross-sectional surveys. Exclusive breastfeeding was the primary dependent variable and defined as the percentage of youngest children under six months exclusively breastfed per last 24 h. The employment status of the mother was the primary independent variable and was coded dichotomously (yes/no). Chi-square analysis assessed the association of EBF with the outcome variable of interest. A multi-level modelling approach has been used for portioning variation in the prevalence of exclusive breastfeeding at different geographical levels.ResultsFrom NFHS rounds 3 to 5, the overall prevalence of exclusive breastfeeding was 47.45%, 54.85%, and 64.01% respectively. On segregating the women as per their employment status, the prevalence among employed women was 51.1%, 51.1%, and 60.3%, while in unemployed women the prevalence was 45.9%, 54.8%, and 67.3% respectively. The odds of practising EBF in NFHS-5 doubled since NFHS-3 (Adjusted Odds Ratio: 2; 95% Confidence Interval: 1.08, 3.67). Employed mothers had a significantly lower odds ratio (0.94, 0.91, 0.98) of practising exclusive breastfeeding. The likelihood increased when mothers were exposed to media, had normal BMI, and visited health centres > 4 times during pregnancy. The likelihood decreased in older mothers, birth of infant in a health facility, female gender of the child, and late initiation of breastfeeding.ConclusionsThe lower prevalence of exclusive breastfeeding among working mothers calls for an urgent need to improve policies around maternity benefits at workplaces.

Maternal characteristics are associated with human milk anti-inflammatory proteins in two populations

Milk anti-inflammatory compounds are ubiquitous in milk but vary greatly within and between populations. The causes of this variation and how this variation impacts infant phenotype is not well-characterized. The goal of this study was to explain how maternal characteristics across two disparate populations impact the levels of TGF-β2 and IL-1ra in human milk. Two populations of mothers, one from rural Kenya and the other from urban U.S., were queried about months since birth, age, sex of infant, height, BMI, triceps skinfold, parity, post-birth resumption of menstrual period, and exclusive breastfeeding. Mothers’ foremilk was assayed for TGF-β2 and IL-1ra as well as % milk fat. Mixed models were used to measure the relationships between maternal characteristics and milk biomarkers, adjusting for population. Statistically significant maternal characteristics were then used to develop path models incorporating infant phenotype. Path results indicated that maternal height and months postpartum significantly predicted milk TGF-β2, which then significantly predicted infant height-for-age. Exclusive breastfeeding and milk fat percent predicted IL-1ra, which was not related to infant weight-for-age. These results have implications for understanding the intergenerational effect of maternal context on infant phenotype via biomarkers in human milk.

Clinical And Socio-Demographic Profile Of Chidren Aged 6-59 Month With Severe Acute Malnutrition Presenting In A Tertiary Care Hospital In Nuh, Haryana

Background: Malnutrition adversely affects achievement of all the milestones namely motor, sensory, cognitive and social. Methods: The records of 150 patients with severe acute malnutrition over a period of one year (July 2022-July 2023) were reviewed, and a statistical comparison of various variables were made. Results: As per study, mean weight(kg) 7.48 ± 2.02, mostly i.e.78.67% were having weight <-3 SD. Mean height or length(cm) was 77.5 ± 11.14 ,majority was in between 2SD to -3SD i.e. 48.00%, MUAC was < 11.5 among 123 (82%), 11.6-12.5 among 10 (6.67%), 12.6-13.5 among 17 (11.33%).There were 41.33% males and 58.67% females.Of study population, Birth order was 1st among 9 (6.0%), 2nd among 11 (7.33%), 3rd among 38 (25.33%) and 4th and above among 92 (61.34%) subjects with a mean of 4.05± 1.52.Among my study most of children were mixed Feeding 53.34%,while only 13.33% were Exclusive breast feed while 33.33% were Top feed .Immunization was Complete among 10.67%, Incomplete among 62.67% and Unimmunized among 26.67% subjects. Pedal Edema was present among 44 (29.33%) subjects and absent in 106(70.67%).The presenting complaint reported were anemia (38.67%), pneumonia (26.67%), acute gastroenteritis (12.67%), hypoglycemia (10.00%), Dehydration (8.0%) and UTI (4.00%) and most common presenting complication wasanemia (80%), followed by pneumonia (52%), acute gastroenteritis (34.00%), dehydration (29.67%), Lethargy/hypoglycaemia (30%), meningitis (8.00%), tuberculosis(5.33%)and UTI (4.00%)As per my study, complication are more severe unvaccinated children, however effect is statistically insignificant (p> 0.05) Conclusion: SAM was most common in 13-24 months age group and with increasing age, a lesser proportion of children were affected with SAM. There was a strong correlation between adverse outcomes and dietary risk factors such as the length of time spent nursing exclusively, using a bottle, and delaying the introduction of supplementary foods. Most common co-morbidities were anaemia and pneumonia.

Effect of Consuming Papaya Leaves, Almond Milk, Green Beans, Moringa Leaves, Ajwa Dates, Soy Milk, and Fennel Leaves on Breast Milk Production in Postpartum Mothers

Exclusive breastfeeding rates are often low due to suboptimal breast milk production, which impedes infants' nutritional needs. This issue is frequently attributed to poor maternal nutrition, unbalanced diets, and irregular food consumption. Breast milk production relies on hormonal changes, notably the dominance of prolactin over progesterone and estrogen during childbirth. To address this, a study was conducted to evaluate the impact of specific foods boiled papaya leaves, almond milk, green beans, moringa leaves, ajwa dates, soy milk, and fennel leaves—on breast milk production. Employing a quasi-experimental design with a one-group pretest-posttest approach, the study involved 56 postpartum mothers whose milk production was substandard. These participants were selected in March 2023 using purposive non-probability sampling. A paired t-test was performed for bivariate analysis. Results indicated a significant improvement in milk production, with a p-value of 0.000, demonstrating that the consumption of these foods positively affects lactation. Consequently, it is recommended that breastfeeding mothers incorporate these foods into their diet to enhance milk production and support exclusive breastfeeding. Regular consumption of these specific foods can help meet infants' nutritional needs more effectively.

Mothers' Gender-role Ideologies and Exclusive Breastfeeding in Western Rural China: A Cross-Sectional Study.

Shifts in women's maternal roles may contribute to the global low prevalence of exclusive breastfeeding. To investigate the association between maternal gender-role ideologies and exclusive breastfeeding in rural China. Cross-sectional studies were conducted in 10 counties in Shaanxi Province using random sampling in 2021 and 2023. Data on breastfeeding practices, maternal gender-role ideology, and expected educational attainment from 586 rural participants were collected through structured questionnaires. Multivariable regression analysis was employed to explore the association between maternal gender-role ideology and exclusive breastfeeding. The prevalence of exclusive breastfeeding within 6 months in rural western China was 18.8%. Women with more egalitarian gender-role ideologies were more likely to engage in exclusive breastfeeding (OR = 1.34, 95% CI [1.04, 1.72]), particularly for female infants (OR = 1.63, 95% CI [1.09, 2.43]). Furthermore, women with stronger egalitarian gender-role ideologies were found to exhibit a greater propensity for financial investment in their children (Beta = 0.20, 95% CI [0.01, 0.40]) and hold higher educational expectations for their daughters (OR = 1.50, 95% CI [1.00, 2.25]). Maternal gender-role ideology positively correlates with exclusive breastfeeding. More policies should be implemented on gender equality in rural China, and cultural perspectives should be incorporated into the analysis of breastfeeding practice.

Determinants of formula feeding among mothers with infants and young children in six Sub Sahara African countries: Multilevel analysis of data from demographic and health survey.

Formula feeding is providing infants with prepared formula as an alternative to or alongside breastfeeding. While breast milk is widely regarded as the optimal source of nutrition for infants, formula feeding is a common practice. The recommended approach is exclusive breastfeeding for the first six months, followed by the introduction of complementary foods after that period, which is crucial for child growth and development. Formal feeding has a negative impact on an infant's health, causing malnutrition and other illnesses. Therefore, this study was investigated to assess formula feeding and determinant factors among mothers with infants in six sub-Saharan African countries. A total weighted sample of 26,119 mothers with infants and young children less than two years was included in this study. The data were taken from a recent demographic and health survey in six sub-Sahara African countries. A multilevel, multivariable logistic regression model was used to identify the determinant factors associated with formula feeding. In the multivariable analysis, the adjusted odds ratio with a 95% CI was used to declare a statistically significant association with formula feeding among mothers with infants. In this study, the proportion of mothers with infants who use formula feeding was 17.1%. In multilevel logistic analysis (model III), the significant factors associated with formula feeding were the age of the mothers; 25-34 years (AOR = 1.3; 95% CI (1.2-1.41)), 35-49 years (AOR = 1.4; 95% CI (1.22-1.54)), multiple children (AOR = 1.4; 95% CI (1.23-1.77)), maternal educational status; secondary and higher (AOR = 2.4; 95% CI (2.11-2.66)), mother's employment status; (AOR = 1.24; 95% CI (1.14-1.5));, richer households (AOR = 1.2; 95% CI (1.10-1.36)), place of delivery (AOR = 2.1; 95% CI (1.83-2.44)), household media exposure (AOR = 1.5; 95% CI (1.3-1.68))place of residence (AOR = 1.97; 95% CI (1.79-2.17)), community illiteracy level (AOR = 1.17; 95% CI (1.02-1.34)), and community media exposure (AOR = 1.2; 95% CI (1.03-1.38)). Formula feeding among mothers with infants in Sub-Saharan Africa has emerged as a public health concern. The recommended approach is to promote exclusive breastfeeding for the first six months, followed by the introduction of complementary feeding after that period. Factors associated with formula feeding include older maternal age, secondary and higher education, delivery in health institutions, employment status, higher household income, twin births, urban residence, low community illiteracy rates, and increased community media exposure. Stakeholders and health policymakers should be focused on strategies to improve breast feeding and discourage infant formula feeding.

Čimbenici majčine odluke o dojenju

Purpose: The aim of the research was to analyze factors that are significantly related to the duration of exclusive breastfeeding and total breastfeeding of mothers from Croatia. Method: The study is cross-sectional, done in the period from December 1st, 2023. until May 1st, 2024. The data about breastfeeding factors was collected from 361 mothers via an online questionnaire. Results: The duration of exclusive breastfeeding statistically significantly correlates with cesarean section, giving a pacifier or a bottle in the first month of the child's life (r = - 0.41), mother's age, the mother's vocational training, the decision to breastfeed being made before pregnancy, the support for breastfeeding in a public place (r = 0.22), previous breastfeeding experience (r = 0.21), the first breastfeeding being done within an hour, rooming, participating in the work of breastfeeding support groups, not providing substitutes for breast milk in the maternity ward (r = 0.29). The total duration of breastfeeding is statistically significantly correlated with the use of tobacco products during pregnancy (r = - 0.45), cesarean delivery, giving a pacifier or bottle in the first month of the child's life (r = - 0.35), not providing substitutes for breast milk in the maternity hospital (r = 0.26), skin-to-skin contact after birth, mothers' participation in breastfeeding support groups (r = 0.27), attending pregnancy courses (both parents), rooming, first breastfeeding being done within an hour (r = 0.21), previous breastfeeding experience, support for breastfeeding in a public place (r = 0.20), decision on breastfeeding being made before pregnancy, vocational education (r = 0.20) mother's age (r = 0.21), and exclusive breastfeeding (r = 0.67). Conclusion: The quality of healthcare workers' help to mothers before, during and after childbirth, significantly affects the success of breastfeeding.

Trajectory of breastfeeding among Chinese women and risk prediction models based on machine learning: a cohort study.

Breastfeeding is the optimal source of nutrition for infants and young children, essential for their healthy growth and development. However, a gap in cohort studies tracking breastfeeding up to six months postpartum may lead caregivers to miss critical intervention opportunities. This study conducted a three-wave prospective cohort analysis to examine maternal breastfeeding trajectories within the first six months postpartum and to develop risk prediction models for each period using advanced machine learning algorithms. Conducted at a leading Maternal and Children's hospital in China from October 2021 to June 2022, data were gathered via self-administered surveys and electronic health records. Of the 3307 women recruited, 3175 completed the surveys, yielding a 96% effective response rate. Breastfeeding(BF) rates were observed at 100%, 96%,93% and 83% at discharge, 42day, 3month and 6month postpartum, respectively. Exclusively breastfeeding(EBF) rates were recorded at 91%, 64%,72% and 58% for the same intervals. Among the five machine learning methods employed, Random Forest (RF) demonstrated superior accuracy in predicting breastfeeding patterns, with classification accuracies of 0.629 and an area under the receiver operating characteristic curve (AUC) of 0.8122 at 42days, 0.925 and an AUC of 0.9800 at 3months, and 0.836 and an AUC of 0.9463 at 6months postpartum, respectively. Key predictive factors for breastfeeding at 42days postpartum included the newborn's birth weight and the mother's pre-delivery and prenatal weights. Predictors for feeding type at 3months and 6months postpartum included early feeding types and the scores from the Breastfeeding Self-Efficacy Scale-short Form (BSES-SF) at 6months. The predictive model based on follow-up data showed strong performance. Breastfeeding rates slightly declined from discharge to 6months postpartum. The breastfeeding context in this region is comparatively optimistic both within China and internationally. Factors such as newborn's birth weight, gestational age, maternal weight management before and during pregnancy, early support and breastfeeding success, breastfeeding knowledge and self-efficacy are intricately linked to long-term breastfeeding outcomes. This study highlights critical, modifiable risk factors for early breastfeeding stages, providing valuable insights for enhancing breastfeeding intervention programs and informed decision-making.

A Cross-Sectional Study of the Maternal Health Factors: The Interplay Between Breastfeeding Patterns, Gut Microbiota, Anemia, and Cardiovascular Risk in Lactating Mothers.

Objective This cross-sectional study explored the interplay between breastfeeding patterns, gut microbiota composition, anemia, and cardiovascular risk in lactating mothers. The study examined how these factors contribute to postpartum maternal and infant health outcomes. Methods Forty-five lactating mothers, with a mean age of 32.73 years, participated in the study. Data on breastfeeding patterns, gut microbiota composition, anemia, and cardiovascular risk factors were collected. Microbial diversity was assessed, and associations with comorbidities and infections were explored. Statistical analyses, including chi-square and Kolmogorov-Smirnov tests, were performed to evaluate the relationships between these variables. Results Among the participants, 35.6% practiced exclusive breastfeeding, and 46.7% were classified as obese (BMI ≥30). Gut microbiota analysis revealed a prevalence of Escherichia coli (31.1%) and Lactobacillus (26.7%). Mothers with lower microbial diversity exhibited higher rates of infections (31.1% yeast infections and 26.7% UTIs) and comorbidities, including gestational diabetes (42.2%) and hypertension (13.3%). Cardiovascular risk was elevated among obese mothers, with 37.8% requiring cardiac medications. Anemia was prevalent, with 42.2% of mothers on folic acid supplements and 31.1% on iron supplements. Conclusion The study highlighted significant associations between obesity, gut microbiota diversity, and cardiovascular risk. Exclusive breastfeeding was linked to a higher prevalence of anemia treatment, suggesting potential nutritional challenges. Further research is necessary to develop interventions targeting maternal health during lactation.

Multicultural doula support and obstetric and neonatal outcomes: a multi-centre comparative study in Norway.

Migrant women face an increased risk of poor obstetric and neonatal outcomes. Norway implemented a multicultural doula (MCD) program in 2018, which was designed to improve pregnancy care for this group in vulnerable circumstances. This study aimed to assess the impact of MCD support, provided in addition to standard care, on obstetric and neonatal outcomes for selected newly arrived migrants. This was a multi-centre case-control study involving all nine hospitals actively running the MCD program, which covers four of Norway's five regions. Women who received MCD support at the time of childbirth (n = 339), from 2018-2023, were compared to similar newly arrived immigrant women who did not receive MCD support (n = 339) and gave birth within the same timeframe. Hospital records were reviewed, and outcomes were analysed using binary logistic regression. The results are expressed as crude and adjusted associations with 95% confidence intervals (CIs). Women receiving MCD support exhibited a 41% lower likelihood of undergoing emergency caesarean sections (adjusted odds ratio [aOR] 0.59, 95% Cl 0.34-0.98) and those giving birth vaginally had a 75% lower risk of estimated blood loss ≥1000ml (aOR 0.25,95% Cl 0.12-0.52) compared with women without MCD support. Additionally, MCD support was associated with more use of pain-relief (aOR 2.88, 95% Cl 1.93-4.30) in labour and increased rates of exclusive breastfeeding at discharge (aOR 2.26, 95% Cl 1.53-3.36). Our study suggests that MCD support may contribute to improved outcomes for migrants in vulnerable circumstances, potentially impacting their future reproductive health and children's well-being.

Inicijativa svjetskih trendova u dojenju: izvješće za Republiku Hrvatsku

Aim: The World Breastfeeding Trends Initiative (WBTi) serves to assess implementation of national infant and young child feeding policies, programs and practices. Results of the assessment are published on the WBTi website. So far, 100 countries have produced a report, including Croatia in 2015 and 2024. In this paper we present the 2024 results for the Republic of Croatia. Methods: A multidisciplinary working group was formed from members of the Croatian Ministry of Health National Breastfeeding Committee. The ten policy and program indicators were scored from 0 to 10, whereas the practice indicators were presented as percentages or absolute numbers. A draft report was sent to 12 partner organisations with an interest in infant and young child feeding. Based on their feedback, the report was revised, translated into English and sent to the WBTi office for validation. Results: The Republic of Croatia received a total score of 66.5 of 100 for its infant and young child feeding policies and programs, placing it third in Europe. Highest scores were obtained for indicators 'National policy, governance and funding' and 'Maternity protection'. Lowest scores were obtained for indicators 'Infant feeding and HIV' and 'Infant and young child feeding during emergencies'. Positive practices related to the introduction of complementary foods and the initiation of breastfeeding within one hour of birth. Exclusive breastfeeding rates, avoidance of bottle feeding and median duration of breastfeeding were scored low. Conclusion: A 'Call to action' is needed in order to improve infant and young child feeding in Croatia.

Knowledge and Attitude towards Exclusive Breast Feeding among Mothers Attending Antenatal Care (ANC) in Brikama District Hospital, Brikama, Gambia

The World Health Organization (WHO) and the United Nations Children's Fund (UNICEF) recommend starting breastfeeding within the first hour after birth, exclusively breastfeeding (EBF) for the first six months, and continuing for up to two years or beyond, in addition to adequate complementary foods. A structured and pretested questionnaire was used to collect data from 384 mothers attending antennal health care at Brikama District Hospital in Brikama, Gambia, from 1st June to 30th June. The mean age (standard deviation (SD)) of the women was 26.69(±5.67) years and ranged from 16 to 49 years. Majority of the women were married (92.19 %) and from extended families (67.19 %). The findings indicate that majority of participants knew about EBF (88.28%) from health workers (58.22%). Furthermore, most mothers preferred breastfeeding for up to two years of age (58.85%) and agreed that babies should be breastfed on demand (65.63%). The knowledge and attitude of mothers towards EBF was very high and positive. Overall, most respondents knew about (85.94%) and favored (69.79%) EBF.

Sex-specific associations between exclusive breastfeeding and postpartum depression in Chinese women

BackgroundStudies on the association of exclusive breastfeeding and postpartum depression (PPD) are inconsistent and no prior study has investigated whether this association was influenced by other factors. This study aimed to investigate the correlation between exclusive breastfeeding and PPD in Chinese population, as well as to determine whether other factors influence this association.MethodsA cross-sectional survey was carried out on 7685 postpartum women from a hospital of Shenzhen, China, utilizing the Edinburgh Postnatal Depression Scale (EPDS) to evaluate PPD.ResultsA total of 7685 women were included this study, of whom 4549 (59.2%) performed exclusive breastfeeding, and 3136 (40.8%) did not carry out exclusive breastfeeding. Puerperal women who exclusively breastfed were found to have a lower risk of testing positive for PPD (10.5% vs. 13.8%, P < 0.001), in comparison to those who were not exclusively breastfeeding. After controlling for other influencing factors, exclusive breastfeeding was still associated with the lower risk of PPD (OR = 0.80, 95% CI, 0.69–0.94). Moreover, stratified analyses suggested that the association of exclusive breastfeeding with PPD was more pronounced in mothers who gave birth to a girl (Pinteraction < 0.05).ConclusionsOur study confirms that the exclusive breastfeeding may reduce the PPD risk, especially among women with a birth of girl. Thus, more tailored preventative approaches should be developed to address PPD in women who were not exclusive breastfeeding.

Does caesarean section have an impact on exclusive breastfeeding? Evidence from four Southeast Asian countries

BackgroundThe effect of caesarean section (CS) on breastfeeding initiation has been extensively studied, but its influence on exclusive breastfeeding practices remains inconclusive. Therefore, this study aims to investigate the impact of CS on exclusive breastfeeding using evidence from four countries in the Southeast Asian region.MethodsThis cross-sectional study used secondary data obtained from the Demographic and Health Surveys (DHS) conducted between 2016 and 2022 in four countries within the Southeast Asian Region. We included information on the youngest children aged 0–5 months living with their mothers within the DHS datasets. The association between CS and exclusive breastfeeding was determined using a simple and multiple logistic regression models. Weight factors were taken into account in all analyses for the two-stage stratified cluster sampling design.ResultsAmong 3420 children, nearly half (49.1%, 95%CI: 47.0, 51.2) were exclusively breastfed. Children born by CS had lower odds of being exclusively breastfed, compared to children born vaginally (aOR = 0.68, 95%CI: 0.53, 0.88). Women who were married or living with a partner (aOR = 2.19, 95%CI: 1.33, 3.60), children born at a health facility (aOR = 1.31, 95%CI: 1.00, 1.71), and girl babies (aOR = 1.24, 95%CI: 1.05, 1.48) had higher odds of exclusive breastfeeding. Furthermore, residing in rural areas was associated with an increased likelihood of exclusive breastfeeding (aOR = 1.47, 95%CI: 1.20, 1.80). Maternal age, mother’s education, parity, antenatal and postnatal care taken, and mass media exposure were not associated with exclusive breastfeeding.ConclusionThis study highlights a significant association between CS and reduced exclusive breastfeeding practices. The findings underscore the importance of providing adequate support and interventions to mothers who deliver by CS and their family members to ensure they can successfully achieve exclusive breastfeeding, particularly in a global context where CS rates are rising.

Breastfeeding interventions and programs conducted in the Islamic Republic of Iran: a scoping review.

The purpose of this review was to identify interventions promoting breastfeeding (BF), BF practices and their outcomes in Iran. Using the PRISMA-ScR Guidelines, we searched across 14 databases for publications published between 2010 and February 2024 to identify studies published in English or Farsi language in peer-reviewed journals, using search terms 'breastfeeding', 'lactation', 'education', 'promotion', 'intervention' and 'program'. Inclusion criteria included intervention-based studies with quantitative outcomes of pregnant women/mothers receiving education, training or other intervention that promoted BF or exclusive BF. Excluded studies were protocols, those examining Iranian communities outside of Iran publications in other languages, brief communications, gray literature and qualitative studies. After screening for relevance, identified articles that met the inclusion criteria were summarized and tabulated using Rayyan QCRI software. Of the 45 identified studies, 37 used randomized-control trial designs, 20 applied theoretical frameworks or specific counseling techniques. Samples included women pregnant for the first time, mothers of babies born prematurely or with low-birth weight, adolescents, mothers who had very young children at home. Only three studies included family members. BF self-efficacy was the most popular variable to assess, which was examined in 32 studies. Almost all studies showed positive results as a result of intervention. Majority of studies were focused at the individual level. No studies were identified that assessed strategies to change routine care or policies that might facilitate BF. Identifying barriers to moving intervention content into standard of care is an important next step in the development of BF research in Iran.

Exclusive breastfeeding: an exploratory thematic analysis of the perspectives of breastfeeding mothers and significant others in the Tamale metropolis of Northern Ghana

IntroductionExclusive breastfeeding is widely recognized as the optimal way to feed infants due to its numerous health benefits for both the child and the mother. Despite its advantages, Ghana is still far from attaining World Health Organization (WHO) recommended rates. This study is aimed at exploring the knowledge attitude and practices, where the practices hinged on facilitators, barriers, and sociocultural perspectives of breastfeeding mothers and significant others on exclusive breastfeeding.MethodsThis study employed an ethnographic thematic analysis framed by the socioecological model (SEM). Thematic analysis was paired with focus group discussions (FGDs). The study participants were recruited purposively by employing a snowball sampling technique with the assistance of community health volunteers. Three (3) FGDs were formed, with 10 participants in each group, to gather perspectives from breastfeeding mothers and significant others (partners and grandmothers) in three communities with Community-based Health Planning and Services (CHPS) compounds within the Tamale metropolis. With an interview guide, all FGDs were audio-taped, transcribed verbatim, and translated from local dialects to English. The emerging themes were used in writing a narrative account, guided by the principles of thematic analysis.ResultsThis study identified three thematic areas: knowledge of exclusive breastfeeding (EBF); attitudes toward EBF and practices of EBF (facilitators, barriers, and sociocultural practices). There was some knowledge disparity among lactating mothers despite the overall high knowledge and subpar attitudes of some mothers. The practice of exclusive breastfeeding was substandard. The major hindrances identified were cultural barriers propagated by partners/husbands and grandmothers; the belief that the weather here does not support EBF; and the need for spiritual herbs in infancy. Supportive healthcare providers helped increase the practice of exclusive breastfeeding. Some support also came from partners and husbands, and some mothers showed unique positive behaviors by exclusively breastfeeding.ConclusionThis study revealed that while exclusive breastfeeding education has been ongoing for decades, sociocultural norms still influence mothers to deviate from WHO recommendations. Public education is recommended to dispel misconceptions surrounding exclusive breastfeeding, develop a food galactagogue to help with breastmilk volumes and create a supportive environment that empowers mothers and families to make informed choices that optimize the health and well-being of both infants and mothers.