Frequency Of Exclusive Breastfeeding Research Articles

The Stunting Determinants in Toddlers from Landak Regency, West Kalimantan: A Cross-Sectional Study

Background: Stunting is a nutrition problem that can slow down the growth. With prevalence at 32.5%, Landak Regency in West Kalimantan has been designated as a stunting hotspot. The lack of a maximum penalty for the stunting case in Landak Regency is not based on factors causing the stunting itself, because there is no identifiable factor causing the stunting in certain area due to narrow roads and sharp curves. Objectives: The objective of this study was to identify causes and distribution of the stunting case in Landak Regency. Methods: A total of 330 households in Meranti, Sebangki, and Senakin were included in this cross-sectional study because they were at a risk of the stunting. Toddlers, mothers, health care, and environmental factors were among the found variables. The researchers employed a basic random sampling strategy for the sampling and used the secondary health center data to find out whether or not toddlers were stunted. Researchers in this study collected data on the independent variables by observing and interviewing participants. Using the chi-square test, the data was analyzed. Results: The results showed that determinants of the stunting in Landak Regency were the history of early breastfeeding initiation (p-value=0.032), exclusive breastfeeding (p-value=0.042), frequency of exclusive breastfeeding (p-value=0.040), the continued breastfeeding (p-value=0.024), complementary feeding (p-value=0.042), immunization history (p-value=0.007), infectious disease history (p-value=0.000), maternal height (p-value=0.046), delivery assistance (p-value=0.000), access to health services (p-value=0.004), the role of health workers (p-value=0.002), and family latrine ownership (p-value=0.000). Conclusions: Several factors were found to be associated with incidence of the stunting among toddlers in Landak Regency.

Association Between Exclusive Breastfeeding and Type 1 Diabetes Mellitus

Objective: to determine the association of formula milk and exclusive breastfeeding (EBF) with type 1 diabetes (TID) in children. Methods: This epidemiology cross-sectional study was conducted in Saidu Teaching Hospital from January-2022 to January-2023. We included 75 patients with diagnosis of TID who presented in diabetes clinic of the hospital. For control group we included 75 children who did not had T1D. Data regarding type of feeding was collected from parent of each child. Results: Mean age was 7.89±2.1 years in patients with T1D and 8.1±1.9 years in control group (p-value 0.52). There were 40 (53.3%) male patients in T1D and 39 (52%) male patients in control group (p-value 0.87). There was very low percentage of exclusive breastfeeding (EBF) in T1D patients; 9 (12%) only in comparison to 43 (57.3%) in controls (p-value <0.001). There was high prevalence of formula feeding in T1D patients; 31 (41.3%) in comparison to 12 (16%) in controls (p-value <0.001). Conclusion: In present study, the frequency of EBF was significantly lower in T1D patients in comparison to controls. So EBF seems to be a protective factor against occurrence of type 1 diabetes. Keywords: Exclusive breastfeeding, Type 1 diabetes, formula feeding.

Frequency of Iron Deficiency Anaemia in Exclusively Breastfed and Infants Fed on Cow’s Milk

Introduction: Iron is the most prevalent nutrient deficiency in infants and young children around the world despite its importance for healthy brain development. Infants who drink whole cow's milk or other animal milks are at a greater risk of developing iron deficiency anaemia. In our culture, cow's milk consumption is widespread. There were no local studies available on iron deficiency anemia in infants using different types of milk so need for the present study was felt. Objectives: The objectives of this study were to determine the frequency of exclusively breastfed and cow’s milk fed infants at 3 month of age and to compare the frequency of iron deficiency anemia in exclusively breastfed and cow’s milk fed infants. Study Design: It was a cross-sectional study. Setting and Duration: Research was conducted at the Medical Outpatient Department of The Children’s Hospital and The Institute of Child Health Lahore from 08/02/2022 to 07/08/2022. Material and Methods: This study involved 220 infants of both genders at 3 months of age presenting for vaccination. Outcome variables were frequency of exclusive breast feeding and iron deficiency anemia. All patients' guardians signed an informed consent form. Results: There were 115 (52.3%) male and 105 (47.7%) female patients in the study group. The Hb of the patients ranged from 7.6 g/dl to 14.5 g/dl with a mean of 11.00±1.98 g/dl while the serum iron level ranged from 41 µg/dl to 115 µg/dl with a mean of 67.94±22.99 µg/dl. Majority of the parents (56.4%) belonged to poor class and 46.4% mothers were illiterate. The frequency of exclusive breastfed infants was 45 (20.5%). There was no significant difference in the frequency of exclusive breast feeding across gender (p=0.873), socioeconomic (p=0.900) and educational (p=0.858) status. 76 (34.5%) Infants had iron deficiency anemia. The frequency of iron deficiency anemia was higher among infants on cow’s milk (37.7% vs. 22.2%) as compared to those on exclusive breast feeding however the observed difference was statistically insignificant (p=0.051). Similar insignificant difference was observed across gender, socioeconomic and educational status groups. Conclusion: The frequency of exclusive breastfed infants was 45 (20.5%). There was no significant difference in the frequency of exclusive breast feeding across gender (p=0.873), socioeconomic (p=0.900) and educational (p=0.858) status. 76 (34.5%) Infants had iron deficiency anemia. The frequency of iron deficiency anemia was insignificantly higher among infants on cow’s milk (37.7% vs. 22.2%; p=0.051) as compared to those on exclusive breast feeding. Similar insignificant difference was observed across gender, socioeconomic and educational status groups. Keywords: Exclusive Breast Feeding, Cow’s Milk Feeding, Iron Deficiency Anemia

The practice of exclusive breastfeeding and factors associated with its interruption

Objective: To investigate the prevalence of exclusive breastfeeding (EA) and factors associated with its interruption among mothers of children from 0 to 6 months of age in the municipality of Santo Antônio de Jesus -BA. Method: Cross-sectional study with 278 mothers, attended in health units of the municipality. Data were collected through interviews. Through hierarchical multiple analysis, a crude and adjusted prevalence ratio (PR), and their respective confidence intervals (95% CI) were calculated. Results: The prevalence of exclusive breastfeeding was 39.6%. The variables race/skin color (nonblack), primiparity, absence of family support for breastfeeding, dissatisfaction during breastfeeding, and pacifier use were associated with interruption of the outcome. Conclusion: The frequency of exclusive breastfeeding was below the indicator recommended by the Ministry of Health. Among the factors that were associated with the interruption of exclusive breastfeeding are socioeconomic characteristics related to reproductive history and lifestyle, as well as conditions related to the child. More effective breastfeeding promotion measures are necessary to mitigate this outcome.

Recommendations For Improving Exclusive Breast Milk For Working Mothers With Health Action Process Approach (Hapa) In Batu Bara District

Mother's Milk (ASI) is the main and best food for babies that have no equal. The benefits of exclusive breastfeeding are enormous, especially for the baby's growth and development, immunity, psychology, and the economy of the baby's parents. Even though the benefits of exclusive breastfeeding are clear for mothers and their babies, the coverage of exclusive breastfeeding for babies is still low. The purpose of this study was to analyze the increase in exclusive breastfeeding for working mothers using the Health Action Process Approach (HAPA) in Batu Bara Regency. The sample of this research is working mothers who have babies 0-6 months in Batu Bara Regency. The sampling technique is Non-Probability Sampling using Total Sampling, where the number of samples is the same as the population of 100 people. The data processing method used Univariate, Bivariate, and Multivariate tests. Theresults showed that self-efficacy, outcome expectations, risk perception, planning, the effect of intention, maintenance, and planning strategies to overcome barriers had a significant effect on breastfeeding practices for working mothers in Batu Bara Regency as evidenced by the p-value of each variable 0.000 <0.05. The multivariate test results show that together the independent variables have a significant effect on the dependent variable, with the most dominant variable being the maintenance variable with an average value of 10.66. The frequency of exclusive breastfeeding and the duration of breastfeeding has no effect on the practice of breastfeeding for working mothers in Batu Bara Regency.

BREASTFEEDING PRACTICES AMONG INFANTS PRESENTING WITH ACUTE DIARRHEA

Objectives: To determine the frequency of different feeding practices among infants presenting with acute diarrhea.
 Material and Methods: This cross sectional study was carried out from October 2019 to March 2020 in the Paediatrics Out-Patient Department of Khyber Teaching Hospital, Peshawar. Infants with acute diarrhea were included in the study after meeting the inclusion and exclusion criteria. Sampling was done by consecutive (non-probability) sampling. Sample size was 141, under WHO sample size calculator.
 
 Results: Out of 141 infants who presented with acute diarrhea in our study, 26(18.4%) were exclusively breastfed, 79(56%) were partially breastfed, while 36(25.5%) were non breastfed. Out of 141, 80(56.7%) were male and 61(43.3%) were female, with frequency of exclusive breastfeeding in males being 17.5% and in females being 19.7%. The mean age of the infant presenting with diarrhea was 3.25 months, while the mean age of the mother in the study was found to be 26.4 years. The rate of exclusive breastfeeding was 7.7% in working mothers compared to 19.5% in housewives.
 
 Conclusion: The most common feeding practice among infants presenting with acute diarrhea is partial breastfeeding which is not as effective as exclusive breastfeeding in preventing and reducing morbidity from diarrheal diseases.
 
 Key Words: Feeding practices, Exclusive breastfeeding, Partial breastfeeding, Non breastfeeding and Acute Diarrhea.

Frequência do aleitamento materno exclusivo aos 30 dias de vida: revisão de estudos longitudinais

Abstract Early life feeding can affect children’s development and survival. Adherence to breastfeeding practices and regular monitoring is essential. This study aims to conduct an integrative review of longitudinal studies on the frequency of exclusive breastfeeding (EBF) at 30 days of life. Articles were retrieved from the PubMed and LILACS databases. The combination of descriptors used was: “prospective study” and “breast feeding.” The search was limited to articles published between 2015 and 2020 in English, Spanish, and Portuguese. We selected 17 original studies. Despite their methodological differences regarding sample size and type, follow-up period, and EBF definition and measurement method, results indicated a high rate of breastfeeding initiation (≥86%) and a wide variation in the occurrence of EBF at 30 days of life (4.5% - 86%) with substantial decline (<60%) in 63% of the investigated areas. These results are far from complying with the recommendation from the World Health Organization of maintaining EBF up to the sixth month of a child’s life and point to the need for further investigations with a standardized methodology to allow for comparisons within and between countries, aiming at planning actions which support breastfeeding.

Exclusive breastfeeding frequency at 30 days of life: review of longitudinal studies

Resumo A nutrição adequada no início da vida pode afetar o desenvolvimento e a sobrevivência infantil, por isso a adesão às práticas de aleitamento materno e o seu monitoramento regular tornam-se essenciais. Este artigo objetiva realizar uma revisão integrativa da literatura sobre a frequência do aleitamento materno exclusivo (AME) aos 30 dias de vida, divulgada em estudos longitudinais. Para isso, foram identificados artigos nas bases de dados PubMed e LILACS. A combinação dos termos de pesquisa foi “estudo prospectivo” e “aleitamento materno”. A busca limitou-se aos artigos em inglês, espanhol e português, e compreendeu as publicações entre os anos 2015 e 2020. Foram selecionados 17 estudos originais. Apesar das diferenças metodológicas entre eles, em relação ao tipo e tamanho de amostra, a definição do AME e método de mensuração, os resultados indicam alta taxa de início da amamentação (≥86%) e ampla variação da ocorrência de AME aos 30 dias de vida (4,5%-86%), com declínio substancial (<60%) em 63% dos locais investigados. Esses resultados distam do cumprimento da recomendação da Organização Mundial da Saúde de AME até o sexto mês de vida, e indicam a necessidade de investigações, com metodologia padronizada, para comparação dentro dos e entre os países, visando ao planejamento de ações para incentivo à amamentação.

Assessment of Barriers to Exclusive Breast Feeding Among Working Saudi Mothers

Background: The World Health Organization and the United Nations International Children’s Fund recommend mothers to exclusively breastfeed their infants for the first six months of their life that should be initiated within the first hour after birth. Methods: This cross-sectional study included currently employed Saudi working mothers residing the Western region of Saudi Arabia. A self-administered questionnaire was distributed through email and social media. Each person meeting the inclusion criteria was provided informed consent, explaining the study aim, and ensuring the confidentiality of information. Data were obtained by filling out the designed Questionnaire. Result: This study included 692 working Saudi mothers. The frequency of exclusive breast feeding was 40.2%, which was continued by 29.8% only after returning to the work. Insufficient breast milk secretion (17.5%) and the lack or minimal support from the workplace for EBF (6.6%) were commonly stated by the mothers. There were great deficiencies in the breastfeeding friendly work policies including the absence of breast feeding or breast milk-pumping place (86.4%), absence of breastfeeding hours during work time (80.9%), and the presence of a strict full-time schedule that did not allow freely use of the nursing break. Conclusion: The present study shows low prevalence of exclusive breast feeding among working mothers in the Western region of Saudi Arabia. Multiple barriers to continuing breast feeding have been detected. Insufficient breast milk secretion and the lack of breastfeeding friendly work policies were common reasons.

Prevalence and predictive factors for exclusive breastfeeding in the first 6 months among mothers attending Primary Health Care Centers in Cairo, Egypt

Abstract Background Although most organizations recommend breastfeeding for at least one year due to its well-known beneficial effects, the prevalence of exclusive breastfeeding in many developing countries was quite low and the current prevalence of breastfeeding and predictive factors for its discontinuation are not well-known. Objectives To identify prevalence and predictive factors affecting exclusive breastfeeding in Primary Healthcare (PHC) Centers in Cairo, Egypt. Methodology A cross sectional study, among mothers attended first six months immunization sessions in three PHC Centers were selected via a convenient sample, A total sample of 180 mothers, 60 from each PHC Center, accepted to participate in our study and were subjected to an interview questionnaire. The questionnaire used was previously validated and pre-tested. Data collection took the period from April to August 2019. Comparison between exclusive and nonexclusive breastfeeding according to possible risk factors was done. Results The frequency of breastfeeding among the participants was 90.6%; however the total (0-6 months) exclusive breastfeeding frequency was only 39.4%. Our logistic regression model showed that exclusive breastfeeding decreased with progressive increase in infant’s age with OR of 0.74, and mothers with good knowledge about proper practice of breastfeeding (e.g. infant’s chin should be immersed in mother's breast and most nipple halo in the infant lower lip) adhered more to exclusive breastfeeding with OR of 2.51. Also, it showed that, during working hours, mothers who fed their infants other than breast milk adhered less to exclusive breastfeeding with OR of 0.19. Conclusions The prevalence of exclusive breastfeeding is quite low, a problem seen in most of developing countries. The predictive factors for exclusive breastfeeding are, younger infant’s age, good knowledge of the mothers about proper practice of breastfeeding, and mothers insisting on breastfeeding during working hours.

Knowledge, attitudes, and breastfeeding practices of postnatal mothers in a tertiary health center

Background: Breastfeeding has several benefits for both the infants and mothers. Despite strong evidences supporting breastfeeding, its prevalence has remained low worldwide. Objective: The objective of the study was to examine the knowledge and attitude toward breastfeeding and infant feeding practices among the Indian postnatal mothers. Materials and Methods: A cross-sectional descriptive study was carried out among randomly selected postnatal mothers at pediatric outpatient department at a tertiary care center. Data were collected by face-to-face interview using a structured questionnaire. Results: Our study showed that a majority of mothers (92%) of mothers were breastfeeders. However, 72% of the mothers were exclusive breastfeeders and 74% of mothers initiated breastfeeding within an hour. While mothers had good knowledge on breastfeeding (11.45±3.45), the average score of the Iowa Infant Feeding Scale (60.45±4.75) indicates neutral attitudes toward breastfeeding. Conclusion: Our findings show that though the frequency of exclusive breastfeeding was high compared to other studies, the gap should be filled. Thus, it is important to provide prenatal education to mothers on breastfeeding. We also recommend strengthening the public health education campaigns to promote breastfeeding.

Determinants of Exclusive Breastfeeding among Mothers in Rawalpindi: A Cross Sectional Study

Background: Exclusive Breast Feeding is one of the most cost effective and simple ways to ensure child health and survival and is the single most instrumental intervention that leads to decreased child mortality and morbidity. This study was done to determine the frequency of exclusive breast feeding among mothers in rural Rawalpindi and to determine the frequency of factors affecting exclusive breast feeding among mothers in rural Rawalpindi. Methods: It was a descriptive cross- sectional study, conducted in 6 months in Union Council Mandra, from November 2014 to April 2015. A sample size of 245was selected through non-probability consecutive sampling. Data was collected on a structured questionnaire from mothers visiting the RHC Mandra facility after taking informed consent. Data was analyzed in the statistical software SPSS 10. Results: The frequency of Exclusive Breast Feeding (EBF) determined in the study was 52.2%. 29% mothers had primary level education, 52.7% had deliveries in the public hospitals and 46.5% were house wives. The birth order, age of the child, number of antenatal visits, birth wt. and mode of delivery (p<0.05) were significantly associated with EBF. The association of mother's and father's education level, monthly income, birth interval and mother's occupation with EBF were not statistically significant (p>0.05). Conclusion: Health education by health professionals during antenatal period to initiate and maintain exclusive breast feeding should be strengthened by focusing more on the nutritional aspects of the newborn babies and its benefits in the later life.

Prevalence and predictive factors for exclusive breastfeeding in the first 6 months among mothers attending Primary Health Care Centers in Cairo, Egypt

Introduction. Although most organizations recommend breastfeeding for at least one year due to its well-known beneficial effects, the prevalence of exclusive breastfeeding in many developing countries was quite low. Aim. To identify prevalence and predictive factors affecting exclusive breastfeeding in Primary Healthcare (PHC) Centers in Cairo, Egypt. Material and methods. A cross-sectional study, among mothers attended first six months immunization sessions in three PHC Centers were selected via a convenient sample, A total sample of 180 mothers, 60 from each PHC Center, were subjected to an interview questionnaire. The questionnaire used was previously validated and pre-tested. Data collection took the period from April to August 2019. Comparison between exclusive and nonexclusive breastfeeding according to possible risk factors was done. Results. The frequency of breastfeeding among the participants was 90.6%; however the total exclusive breastfeeding frequency was only 39.4%. Our logistic regression model showed that exclusive breastfeeding decreased with progressive increase in infant’s age (OR 0.74), and mothers with good knowledge about proper practice of breastfeeding adhered more to exclusive breastfeeding (OR 2.51). Also, it showed that, during working hours, mothers who fed their infants other than breast milk adhered less to exclusive breastfeeding (OR 0.19). Conclusion. The prevalence of exclusive breastfeeding is quite low. The predictive factors for exclusive breastfeeding are, younger infant’s age, good knowledge of the mothers about proper practice of breastfeeding, and mothers insisting on breastfeeding during working hours.

Down syndrome and breastfeeding: A systematic review.

Several conditions related to serious difficulty in initiating and maintaining breastfeeding in neonates with Down syndrome are described in the literature. This study aimed to investigate the frequency of breastfeeding in neonates with Down syndrome, as well as the reasons for not breastfeeding, through a systematic literature review by searching MEDLINE via PubMed, Cochrane Library, Scopus, Embase via Elsevier, and Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases. Sixteen studies were included with a total sample size of 2022 children with Down syndrome. The frequency of exclusive breastfeeding was 31.6-55.4%, with five studies reporting breastfeeding for longer than 6 months. Breastfeeding from birth was present for 48-92.5% of the children with Down syndrome in six studies. Two studies reported that around 50% and 23.3% of the children with Down syndrome were never breastfed, and rates of breastfeeding in infants with Down syndrome were lower than those in controls in three studies. The reasons for not breastfeeding or cessation of breastfeeding were associated with Down syndrome-specific challenges, maternal reasons, and healthcare aspects.

The relationship between the type of nutrition and anthropometric indices of infants during the first year of birth

Background: Considering the importance of proper infant nutrition, especially in the first two years of life, and also the effect of cultural subjects on the type of infant's nutrition, this study aimed to investigate the type of nutrition and anthropometric indices of infants during the first year of birth in Bushehr, Iran. Methods and materials: This cross-sectional study carried out on 546 delivered mothers. The data of mothers and their children were collected through Integrated Health System (SIB). Five centers of comprehensive health care centers were randomly selected. Required information included maternal demographic characteristics and anthropometric indices of infants at birth, 6 and 12 months. The collected data were analyzed using SPSS 19 with appropriate statistical tests at a significance level of p Results: The frequency of exclusive breastfeeding, formula feeding and also both feeding methods (combined) were 56.8%, 25.1%, and 18.1%, respectively. The results showed that 6-month weight gain compared to birth time did not differ between the three groups. The increase in height and head circumference in the first six months in the formula feeding group was less than the exclusive breastfeeding group and the combined group (p <0.05). In the second six months, weight gain and height in formula feeding group were less than the other two groups (P <0.01). Conclusion: This study showed that the prevalence of exclusive breastfeeding in Bushehr is desirable with good condition compared to the whole country of Iran. The growth trend in breastfed infants is either similar or better than formula-fed infants. Use of formula with breast milk compared to formula alone has better growth outcomes.

Effects of journal therapy counseling with anxious pregnant women on their infants\u2019 sleep quality: a randomized controlled clinical trial

BackgroundSleep is especially important for infants, since it stimulates the development of neural connections in their brains. Psychological stress such as anxiety could affect sleep quality. This study investigated the effects of journal therapy counseling sessions on the infants’ sleep quality based on mothers’ perception (primary outcome), maternal anxiety, infants’ anthropometric and developmental parameters, and the frequency of exclusive breastfeeding (secondary outcomes).MethodsA total of 70 healthy women with gestational age of 28–31 weeks participated in this randomized controlled trial. The participants were randomly allocated into intervention and control groups using randomized block design. Three in-person journal therapy sessions and three telephone counseling sessions (2 between in-person sessions and 1 one month postpartum) were provided to those in the intervention group, while the control group only received routine care. The Infant Sleep Questionnaire (ISQ), Exclusive Breastfeeding Checklist, and Infant Anthropometric Parameters Checklist were completed at two and four months postpartum. The Beck Anxiety Inventory (BAI) was completed during pregnancy, at the end of the intervention, and at two and four months postpartum, and the Ages and Stages Questionnaire (ASQ) was completed at 4 months postpartum. Data were analyzed using chi-square, independent t-test, ANCOVA and repeated measure ANOVA.ResultsThere was no significant difference between the two groups in demographic characteristics and baseline anxiety scores. The mean sleep quality score in infants two months of age (MD: -4.2; 95%CI: − 1.1 to − 7.2; P = 0.007) and four months of age (MD: -5.5; 95%CI: − 8.4 to − 2.7; P < 0.001) was significantly lower in the intervention group than that of those in the control group. Based on the repeated measure ANOVA results, the mean postpartum anxiety score of mothers in the intervention group was significantly lower than that of those in the control group (AMD: -7.7; 95%CI: − 5.5 to − 10.1; P < 0.001). There was no significant difference between the two groups regarding other outcomes including the frequency of exclusive breastfeeding, and anthropometric and developmental parameters (P > 0.05).ConclusionJournal therapy can decrease mothers’ anxiety and improve the infants’ sleep quality based on their perception. However, further studies are required before drawing any definitive conclusion.Trial registration numberIranian Registry of Clinical Trials (IRCT): IRCT20120718010324N45. Date of registration: August 11, 2018. URL: https://en.irct.ir/trial/33211.

Frequency of Breast feeding among working women of Multan.

Objectives: To determine the frequency of exclusive breast feeding among working women of Multan and to identify associations between socio demographic factors and exclusive breast feeding. Study Design: Descriptive cross sectional study. Setting: Public and private organizations of Multan city. Period: From 22-07-2017 to 25-05-2018. Material &amp; Methods: The total 227 working women were enrolled by nonprobability purposive sampling technique. Data was collected on a predefined questionnaire. Results pertaining to rates were reported as frequencies and percentages. Post stratification Pearson chi square test was applied to identify significance of associations between socio demographic factors of working women and exclusive breast feeding. Result: Mean age of our study cases was 28.24 ± 9.01. The frequency of exclusive breast feeding was noted as 44.5%. Post stratification Pearson chi square test revealed statistically significant associations between of certain socio demographic factors and exclusive breast feeding. Working women of younger than 30 years of age, urdu speaking ethnicity, banker by profession, living in nuclear family, more than 36 hours of work in a week, more than three children and shorter than two years of inter pregnancy interval were less likely to practice exclusive breast feeding. Conclusion: The frequency of exclusive breast feeding was below the rate of exclusive breast feeding in the general population of Pakistan as well as below those recommended by World Health Organization (WHO). Evaluations of national health policy and awareness campaigns are needed to increase the rate of exclusive breast feeding in working women.

Timing of Circumcision and Breastfeeding Frequency: A Multi-Center, Prospective, Randomized Clinical Trial

Purpose: Many newborn providers believe that early circumcision (before 24 hours of life) interferes with breastfeeding. Limited observational studies do not support an association between circumcision and breastfeeding initiation or duration. Our specific research aim is to determine if the timing of newborn circumcision affects breastfeeding exclusivity in the first 6 months of life. Methods: We conducted a multicenter, prospective, clinical trial wherein mother-infant dyads across three clinical sites were randomized to one of three circumcision timing groups, defined as: 1) early, age 6-24hrs, 2) standard, age 24-72hrs, or 3) late, age 1-3 weeks. Exclusion criteria included gestational age <38 weeks, multiple delivery, NICU admission or observation, no maternal intention to breastfeed at time of delivery, and parents declining circumcision for their newborn. We collected data on feeding method at time of nursery discharge, and at 2-weeks, 2 months, 4 months and 6 months of age. One-way ANOVA and Fisher’s exact tests were used to determine any statistical differences among characteristics of our three study groups. Fisher’s exact test was then used to determine if there was a significant relationship between circumcision timing and breastfeeding frequency at each of our measured time points. Results: One hundred and three mother-infant dyads have been enrolled to date. Thirty-seven infants have been randomized to have early circumcision performed at <24hrs, and thirty-six have been randomized to the standard (24-72hr) group. The remaining 30 infants have had late circumcisions performed in the outpatient setting at 1-3 weeks of age. There are no statistically significant differences among our three study groups. The frequency of exclusive breastfeeding in the early circumcised group is significantly higher from 2 weeks through 6 months. There is a statistically significant decrease in breastfeeding frequency from hospital discharge through six months of age in the stardard and late circumcision groups. Conclusion: Early circumcision of otherwise healthy, term males has no deleterious effects on breastfeeding initiation and maintenance. In fact, early circumcision (<24hrs) is associated with significantly higher breastfeeding frequency at all measured time points in our study. Hospital policies need not place limitations on circumcision prior to 24 hours of life due to concerns regarding breastfeeding. Deferment of circumcision to the outpatient setting after breastfeeding establishment may not improve breastfeeding outcomes.

The burden and underlying determinants of under nutrition among under five year children in Gurage Zone

Background: Malnutrition is one of the most common causes of morbidity and mortality in children under the age of five year. However, in Gurage zone information about the prevalence and associated factors of malnutrition still limited.&#x0D; Aims and Objectives: The major objective of this study was assessing the burden and determinants of malnutrition among under five children.&#x0D; Materials and Methods: A community based cross-sectional study design was applied from December 25, 2016 to April 25, 2017. A total of 1040 eligible mothers were interviewed using structured interviewer administered questionnaires by trained data collectors working in pediatrics ward. Through systematic sampling technique study participant were included in the study. To test the existence of statistical relationship between independent and dependent variables multiple logistic regressions analysis was used.&#x0D; Results: The prevalence of malnutrition among study children was 38.8%. Logistic regressions analysis result indicated that Unimproved sanitation [AOR 1.58 (95% CI 1.13-2.2)], food insecurity [AOR 2.06 (CI 3.49-3.33)], maternal disempowerment [AOR 4.1(CI 2.69-6.24)], inadequate frequency of exclusive breast feeding [AOR 1.9 (95% CI 1.176-3.357]. showed a significant association with malnutrition.&#x0D; Conclusion: The prevalence of malnutrition among under five year children living in Gurage zone was 38.8%. It was associated with utilization of unimproved sanitation, maternal disempowerment, food insecurity. Hence to abort the problem, it is better to enhance house hold food security, exclusive breast feeding, maternal empowerment and utilization of improved sanitation.

Online participatory intervention to promote and support exclusive breastfeeding: Randomized clinical trial.

The support offered to mothers after hospital discharge can be decisive in maintaining exclusive breastfeeding during the first 6months post-partum. The objective of this study was to assess the impact on the duration of exclusive breastfeeding of a participatory intervention using an online social network. A randomized clinical trial was performed involving 251 mother-child pairings in a university hospital in the Northeast of Brazil, 123 of which assigned to the intervention group and 128 to the control group. After hospital discharge, the intervention group was followed through a closed group of an online social network, where weekly posters were published on topics related to breastfeeding and an active communication was established with the mothers. The groups were interviewed monthly over the phone until the child reached 6months of age. The duration of exclusive breastfeeding was calculated through survival analysis, and the effect of the intervention was estimated through the Cox regression model. The exclusive breastfeeding frequencies were higher in the intervention group in all follow-up months, reaching 33.3% in the sixth month versus 8.3% in the control group. The median exclusive breastfeeding duration was 149days (95% CI [129.6, 168.4]) in the intervention group and 86days (95% CI [64.9, 107.1]) in the control group (P<0.0001). The proportional risk of early interruption of exclusive breastfeeding was 0.38 (95% CI [0.28, 0.51], P<0.0001). This intervention had a positive impact on the duration and frequency of exclusive breastfeeding.