Longer Duration Of Breastfeeding Research Articles

Breastfeeding in relation to risk of different breast cancer characteristics

BackgroundThe aim of this present study was to examine duration of breastfeeding in relation to the risk of different subgroups of breast cancer. A prospective cohort, The Malmö Diet and Cancer study, including 14092 parous women, were followed during a mean of 10.2 years and a total of 424 incident breast cancers were diagnosed.MethodsTumours were classified regarding invasiveness, tumour size, axillary lymph node status, Nottingham grade, tumour proliferation (Ki67), HER2, cyclin D1 and p27, WHO histological type and hormone receptor status. Duration of breastfeeding was measured using total time of breastfeeding, categorized in quartiles using the lowest as the reference group (<4.0, ≥4.0- < 8.0, ≥8.0- < 13.0 and ≥13.0 months). Average duration of breastfeeding per child and breastfeeding duration of the first child were also used as exposures in separate analyses. Relative risks, with 95% confidence intervals, were obtained using a Cox’s proportional hazards analysis adjusted for potential confounders.ResultsOverall risk for breast cancer was similar in all quartiles of breastfeeding. No strong results regarding breastfeeding duration and breast cancer subgroups were seen. A few results indicated an association between a relatively long duration of breastfeeding and tumours with high proliferation (Ki67) and grade III histological grade.ConclusionsBreastfeeding duration was not associated with breast cancer risk and no strong results were seen with regard to breast cancer subgroups.

Metabolomic analysis reveals amino-acid responses to an oral glucose tolerance test in women with prior history of gestational diabetes mellitus

ObjectiveAlthough gestational diabetes mellitus (GDM) is associated with an increased risk of type 2 diabetes mellitus (T2DM) compared to normoglycemic pregnancies, the biochemical pathways underlying the progression of GDM to T2DM are not fully elucidated. The purpose of this exploratory study was to utilize metabolomics with an oral glucose tolerance test (OGTT) to examine the amino acid response in women with prior GDM to determine if a relationship between these metabolites and established risk factors for T2DM exists. Materials/methodsThirty-eight non-pregnant women without diabetes but with prior GDM within the previous 3 years were recruited from a community-based population. A 75 g-OGTT was administered; fasting and 2-h plasma samples were obtained. Metabolite profiles of 23 amino acids or amino acid derivatives were measured with gas chromatography-mass spectrometry. Measures of insulin resistance were derived from the OGTT and risk factors for T2DM were obtained by self-report. ResultsTwenty-two metabolite levels decreased significantly in response to the OGTT (p < 0.05). The clinical covariates most powerfully associated with metabolite level changes included race, body mass index (BMI), and duration of prior breastfeeding, (mean ± SD of standardized β-coefficients, β = −0.38 ± 0.05, 0.25 ± 0.08, and 0.44 ± 0.03, respectively, all p < 0.05). Notably, a prior history of breastfeeding was associated with the greatest number of metabolite changes. ConclusionsGreater change in metabolite levels after a glucose challenge was significantly associated with a longer duration of breastfeeding and higher BMI. Further exploration of these preliminary observations and closer examination of the specific pathways implicated are warranted.

Development of Environmentally Friendly Messages to Promote Longer Durations of Breastfeeding for Already Breastfeeding Mothers

Durations of breastfeeding activity in the United States fall short of established recommendations by leading public health institutions. In response to this problem, this study sought to develop environmentally friendly messages to promote continued breastfeeding for moms already breastfeeding in order to help them reach recommended breastfeeding durations. Messages were successfully cultivated to encourage moms already breastfeeding to meet recommended breastfeeding durations. In addition, this study cultivated strategies by which to use environmentally friendly messages to urge mothers who still need to decide whether to breastfeed or formula feed to breastfeed, although this was not the purpose of the research. Avenues for future communication-based breastfeeding research were also elucidated. The Elaboration Likelihood Model serves as useful theory to assess the role of environmentally friendly messages in the promotion of continued breastfeeding.

Early infant feeding practice and childhood obesity: the relation of breast-feeding and timing of solid food introduction with childhood obesity.

We assessed the association of breast-feeding and timing of solid food introduction with childhood obesity. The children were grouped according to the duration of breast-feeding (0-1, 2-6, 7-12, 13-18, and 19-24 months) and the age at which solid foods were introduced (<4, 4-5, and ≥6 months). In this study, we enrolled 4990 children aged 2-14 years. The rate of exclusive breast-feeding at 6 months of age was 49.1%. We found no association between the duration of breast-feeding and childhood obesity [odds ratio (OR) 0.948, 95% confidence interval (95% CI) 0.694-1.295]. The regression analysis revealed no significant differences in obesity or overweight rates between the early and late introduction to solid food groups (OR 0.993, 95% CI 0.645-1.531). Although breastfeeding has been previously reported to protect against childhood obesity, we were unable to find a significant association between obesity and either longer duration of breastfeeding or later introduction to solid foods in our sample.

Assessment of factors affecting afterpain in multiparous women delivered in Mashhad 17-Shahrivar Hospital, Mashhad, Iran

Background: Afterpain is a common phenomenon after vaginal delivery. Any factor that causes a delay in the process of uterus sub involution and consequently returning its size to pre-pregnancy status could affect the severity of afterpain. This study aimed to investigate the factors related to afterpain in multiparous women delivered in 17-Shahrivar Hospital, Mashhad, Iran. Methods: In this descriptive study 210 multiparous women during 2-4 hours after uncomplicated spontaneous vaginal delivery with moderate or severe afterpain were conveniently selected and included in the study. Afterpain was measured each hour during the first 12 hours of postpartum period using Visual Analogue Scale (0-100 mm). The duration of lactation and ambulation, the need for any medication to relieve afterpain and also vital signs were recorded during this period. Data were analyzed with SPSS Version 14, using t Student and correlation test. Results: The mean score of afterpain severity was 55.1±16.7. There was a positive correlation between the number of pregnancies and the duration of breastfeeding with mean score of afterpain. Also the length of ambulation decreased the afterpain intensity. However, the intensity of afterpain had no significant relationship with stimulation with oxytocin in labor, prescription of methyl ergonowin and also oxytocin after delivery. Conclusion: Considering that longer duration of breast feeding and ambulation in early postpartum period could decrease afterpain, it is suggested to encourage postpartum mothers to begin breast feeding and ambulation as soon as possible after birth.

The comparison of parents' educational level on the breastfeeding status between turkman and non-turkman ethnic groups in the north of iran.

Background:Mother's milk plays an important role in infant's health, and World Health Organization (WHO) recommends infants should be breastfed for 2 years or up.Aim:The main objective of this study was to evaluate the breastfeeding status based on parents’ educational level with comparison between Turkman and non-Turkman ethnic groups in the North of Iran in 2010.Subjects and Methods:This is a descriptive, cross-sectional study, which was carried out on 6519 subjects (3897 = non-Turkman and 2622 = Turkman) in urban and rural areas. Data have been collected through interviewing with primary school children's mothers. The schools and students were selected using multi-cluster random sampling methods. Breastfeeding was defined based on WHO predominant definition.Results:Of all mothers, 5.8% (377/6519) breastfed for 6 months, 34.8% (2265/6519) for 7-18 months, 57.4% (3745/6519) for 18-24 months and 2% (132/6519) didn’t breastfeed their infants. Breastfeeding prevalence at 19-24 months in Turkman ethnic group (64.7%; 1696/2622) was significantly more than in non-Turkman ethnic group (52.6%; 2049/3897) (P < 0.01) besides early weaning prevalence (at 6 months) in Turkman group was significantly less than in non-Turkman group (4.7%; 123/2622 vs. 6.5%; 254/3897) (P < 0.01). Odds ratio for weaning before 6 months in non-Turkman mothers were 0.563 (0.365-0.786, confidence interval [CI] 95%) in 1-12 years schooling and 0.665 (0.486-0.910, CI: 95%) in uneducated groups compared to college educated. This ratio in Turkman fathers was 3.413 (1.726-6.746, CI: 95%) in 1-12 years schooling compared with college educated.Conclusion:The duration of breastfeeding was longer among Turkman compared with non-Turkman mothers, and longer duration of breastfeeding was associated with higher educational level in the Turkman but not in the non-Turkman mothers.

Breastfeeding and risk of atopic dermatitis up to the age 42 months: a birth cohort study in Japan

PurposeThe purpose of this study was to investigate the association between breastfeeding and atopic dermatitis (AD) up to the age 42 months. MethodsData from a nationally representative population-based birth cohort study in Japan were used (N = 38,757). Feeding pattern and breastfeeding duration were investigated via questionnaires when infants were aged 6 months. Physician-diagnosed AD during the previous 1 year was ascertained via questionnaires when the children were aged 18, 30, and 42 months. The associations between feeding patterns or breastfeeding duration and physician-diagnosed AD from the age 6 to 42 months, categorized by AD status (no history of AD, episodic AD, and persistent AD), were analyzed using ordered logistic regression adjusted for covariates. ResultsBreastfeeding was positively associated with AD, with dose-response association (P for trend < .001). Exclusively breastfed infants were 1.26 times more likely to have AD (95% confidence interval, 1.12–1.41) than infants fed formula alone. Furthermore, children with a longer breastfeeding duration were also significantly more likely to have AD (P for trend < .001). ConclusionsBreastfeeding is associated with an increased risk of AD up to the age 42 months. Further study is needed to elucidate the mechanism underlying the association between breastfeeding and AD.

Telephone-based support prolongs breastfeeding duration in obese women: a randomized trial

Obese women often have difficulties breastfeeding. We evaluated whether telephone-based support could increase the duration of breastfeeding in obese women and, thereby, reduce offspring growth. We recruited 226 dyads of obese mothers and their singleton, healthy, term infants. The women were randomly assigned to 6 mo of breastfeeding support or standard care controls. At 6 mo, there were 207 dyads in the study; 105 dyads received support, and 102 dyads were control subjects. One International Board Certified Lactation Consultant carried out the intervention, which was based on structured interviews and consisted of encouraging telephone calls. The support group breastfed exclusively for a median of 120 d (25th-75th percentiles: 14-142 d) compared with 41 d (3-133 d) for control subjects (P = 0.003). Any breastfeeding was maintained for a median of 184 d (92-185 d) for the support group compared with 108 d (16-185 d) for control subjects (P = 0.002). Support increased the adjusted ORs for exclusive breastfeeding at 3 mo and the ratios for partial breastfeeding at 6 mo to 2.45 (95% CI: 1.36, 4.41; P = 0.003) and 2.25 (95% CI: 1.24, 4.08; P = 0.008, respectively). Although the duration of exclusive breastfeeding was inversely associated with infant weight (β = -4.39 g/d; 95% CI: -0.66, -8.11 g/d; P = 0.021) and infant length at 6 mo (β = -0. 012 cm/d; 95% CI: -0.004, -0.02 cm/d; P = 0.004), the breastfeeding support did not achieve a significant effect on infant growth at 6 mo (n = 192). Telephone-based advisory support was very effective in prolonging breastfeeding in obese mothers who often terminate the breastfeeding of their infants prematurely. A longer duration of breastfeeding may decrease risk of noncommunicable diseases in these infants. This trial was registered at clinicaltrials.gov as NCT01235663.

Neonatal isolated rectal bleeding and the risk of hypersensitivity syndromes

When rectal bleeding occurs in an otherwise asymptomatic child, it can be classified as isolated rectal bleeding (IRB). Among the different etiologies suggested for IRB, one of the most common is a hypersensitivity reaction of the bowel mucosa to digested antigens. The objective of this study was to assess the long-term outcomes and the risk of developing hypersensitivity syndromes among infants following an IRB event. A historical prospective comparative study was carried out. The study compared 77 infants who were born at the Sheba Medical Center in Israel during the period 2002 to 2009 and who experienced a neonatal IRB event to 77 infants with the same gestational age, but without IRB. Data were obtained from hospital records and from phone interviews with the parents regarding hypersensitivity syndrome between the ages of 3 and 10 years. The IRB group was not at an increased risk of developing a hypersensitivity syndrome or gastrointestinal symptoms compared to the control group. Longer duration of breast-feeding was found to be related to a lower incidence of hypersensitivity symptoms. An IRB event in the neonatal period does not increase the risk of developing hypersensitivity syndromes or food allergies during childhood.

Delivery Room Breastfeeding for Prevention of Hypoglycaemia in Infants of Diabetic Mothers

Objective: To evaluate the effect of duration of early breastfeeding in the delivery room on blood glucose levels among term neonates of diabetic mothers. Methods: Mothers with gestational diabetes were encouraged to breastfeed their infants immediately after birth in the delivery room. The breastfeeding duration was recorded by the midwife. Results: The longer duration of breastfeeding subgroup (n = 39) demonstrated a lower rate of hypoglycaemia in the first 8 hours of life (< 40 mg/dl) compared to the shorter duration subgroup (n = 40), but this difference did not reach statistical significance (2.6% vs. 17.5% respectively, p = 0.057). Hypoglycaemia was mainly predicted by lower cord glucose for each decrease of 10 mg/dl (OR 2.11 [CI 1.1–4.03] p = 0.024. Conclusion: Longer duration of delivery room breastfeeding did not reduce the rate of hypoglycaemia, which was mainly influenced by lower cord blood glucose level.

Breastfeeding and ovarian cancer risk: a meta-analysis of epidemiologic studies

Epidemiologic studies have yielded inconsistent findings between breastfeeding and epithelial ovarian cancer (EOC) risk. We performed a meta-analysis to summarize available evidence of the association between breastfeeding and breastfeeding duration and EOC risk from published cohort and case-control studies. Relevant published studies were identified by a search of MEDLINE through December 2012. Two authors (T-TG and Q-JW) independently performed the eligibility evaluation and data abstraction. Study-specific RRs from individual studies were pooled by using a random-effects model, and heterogeneity and publication-bias analyses were conducted. Five prospective and 30 case-control studies were included in this analysis. The pooled RR for ever compared with never breastfeeding was 0.76 (95% CI: 0.69, 0.83), with moderate heterogeneity (Q = 69.4, P < 0.001, I(2) = 55.3%). Risk of EOC decreased by 8% for every 5-mo increase in the duration of breastfeeding (RR: 0.92; 95% CI: 0.90, 0.95). The risk reduction was similar for borderline and invasive EOC and was consistent within case-control and cohort studies. Results of this meta-analysis support the hypothesis that ever breastfeeding and a longer duration of breastfeeding are associated with lower risks of EOC. Additional research is warranted to focus on the association with cancer grade and histologic subtypes of EOC.

Influence of Macrosocial Policies on Women's Health and Gender Inequalities in Health

Gender inequalities in health have been widely described, but few studies have examined the upstream sources of these inequalities in health. The objectives of this review are 1) to identify empirical papers that assessed the effect of gender equality policies on gender inequalities in health or on women's health by using between-country (or administrative units within a country) comparisons and 2) to provide an example of published evidence on the effects of a specific policy (parental leave) on women's health. We conducted a literature search covering the period from 1970 to 2012, using several bibliographical databases. We assessed 1,238 abstracts and selected 19 papers that considered gender equality policies, compared several countries or different states in 1 country, and analyzed at least 1 health outcome among women or compared between genders. To illustrate specific policy effects, we also selected articles that assessed associations between parental leave and women's health. Our review partially supports the hypothesis that Nordic social democratic welfare regimes and dual-earner family models best promote women's health. Meanwhile, enforcement of reproductive policies, mainly studied across US states, is associated with better mental health outcomes, although less with other outcomes. Longer paid maternity leave was also generally associated with better mental health and longer duration of breastfeeding.

The influence of early feeding practices on fruit and vegetable intake among preschool children in 4 European birth cohorts

Fruit and vegetable intake in children remains below recommendations in many countries. The long-term effects of early parental feeding practices on fruit and vegetable intake are not clearly established. The purpose of the current study was to examine whether early feeding practices influence later fruit and vegetable intake in preschool children. The study used data from 4 European cohorts: the British Avon Longitudinal Study of Parents and Children (ALSPAC), the French Etude des Déterminants pre et postnatals de la santé et du développement de l'Enfant study, the Portuguese Generation XXI Birth Cohort, and the Greek EuroPrevall study. Fruit and vegetable intake was assessed in each cohort by food-frequency questionnaire. Associations between early feeding practices, such as breastfeeding and timing of complementary feeding, and fruit and/or vegetable intake in 2-4-y-old children were tested by using logistic regressions, separately in each cohort, after adjustment for infant's age and sex and maternal age, educational level, smoking during pregnancy, and maternal fruit and vegetable intake. Large differences in early feeding practices were highlighted across the 4 European cohorts with longer breastfeeding duration in the Generation XXI Birth Cohort and earlier introduction to complementary foods in ALSPAC. Longer breastfeeding duration was consistently related to higher fruit and vegetable intake in young children, whereas the associations with age of introduction to fruit and vegetable intake were weaker and less consistent across the cohorts. Mothers' fruit and vegetable intake (available in 3 of the cohorts) did not substantially attenuate the relation with breastfeeding duration. The concordant positive association between breastfeeding duration and fruit and vegetable intake in different cultural contexts favors an independent specific effect.

Predictors of Serum Chlorinated Pesticide Concentrations among Prepubertal Russian Boys

Background: Few studies have evaluated predictors of childhood exposure to organochlorine pesticides (OCPs), a class of lipophilic persistent chemicals.Objectives: Our goal was to identify predictors of serum OCP concentrations—hexachlorobenzene (HCB), β-hexachlorocyclohexane (β-HCH), and p,p-dichlorodiphenyldichloroethylene (p,p´-DDE)—among boys in Chapaevsk, Russia.Methods: Between 2003 and 2005, 499 boys 8–9 years of age were recruited in a prospective cohort. The initial study visit included a physical examination; blood collection; health, lifestyle, and food-frequency questionnaires; and determination of residential distance from a local factory complex that produced HCB and β-HCH. Fasting serum samples were analyzed for OCPs at the U.S. Centers for Disease Control and Prevention. General linear regression models were used to identify predictors of the boys’ serum HCB, β-HCH, and p,p´-DDE concentrations.Results: Among 355 boys with OCP measurements, median serum HCB, β-HCH, and p,p´-DDE concentrations were 158, 167, and 284 ng/g lipid, respectively. Lower body mass index, longer breastfeeding duration, and local dairy consumption were associated with higher concentrations of OCPs. Boys who lived < 2 km from the factory complex had 64% (95% CI: 37, 96) and 57% (95% CI: 32, 87) higher mean HCB and β-HCH concentrations, respectively, than boys who lived ≥ 5 km away. Living > 3 years in Chapaevsk predicted higher β-HCH concentrations, and having parents who lacked a high school education predicted higher p,p´-DDE concentrations.Conclusions: Among this cohort of prepubertal Russian boys, predictors of serum OCPs included consumption of local dairy products, longer local residence, and residential proximity to the local factory complex.Citation: Lam T, Williams PL, Burns JS, Sergeyev O, Korrick SA, Lee MM, Birnbaum LS, Revich B, Altshul LM, Patterson DG Jr, Turner WE, Hauser R. 2013. Predictors of serum chlorinated pesticide concentrations among prepubertal Russian boys. Environ Health Perspect 121:1372–1377; http://dx.doi.org/10.1289/ehp.1306480

Breast cancer and some epidemiological factors: a hospital based study

Objective: The aim of this study was to determine risk factors associated with breast cancer in the National Institute of Cancer Research and Hospital, Dhaka, Bangladesh. Methodology: A case control study was conducted from July 2009 to June 2010, on 262 biopsy proven cases of breast cancer from National Institute of Cancer Research and Hospital and 262 matched controls of acute diseases from Dhaka Medical College Hospital. Religion, residential status and age (±2 years) were matched. Statistical analysis was carried out using conditional logistic regression, odds ratios, chi-square and t- test with SPSS software (V-17). Results: Multivariate analysis showed that higher education (OR=1.72), personal income (OR=5.71), history of induced abortion (OR= 20.62), history of breast feeding (OR= 7.91), OCP users (OR= 1.47), current smokers (OR=6.78), personal history of breast disease (OR=10.99), family history of breast cancer (OR=3.85) and family history of other cancer (OR=2.21) were risk factors for breast cancer. Furthermore, having menarche at an early age (OR=0.35), giving birth to an early age (OR= 0.35), early menopause (OR= 0.22), longer duration of breast feeding (OR=0.30), parity of 2 and more (OR=0.29) and regular physical activity (OR=0.58) were shown to be protective factors. Conclusion: Physical inactivity, being menopause, positive family history of breast cancer and history of induced abortion were found important risk factors. Longer duration of breast feeding should be encouraged for its protective effect. Study revealed that the women who have one or more of the above risk factors should be given special attention for breast cancer prevention DOI: http://dx.doi.org/10.3329/jdmc.v22i1.15628 J Dhaka Medical College, Vol. 22, No. 1, April, 2013, Page 61-66

Breastfeeding Behavior Among Adolescents: Initiation, Duration, and Exclusivity

Despite a substantial amount of evidence on breastfeeding among non-adolescent mothers, research and strategies uniquely designed to target adolescent mothers are critical because their rates of breastfeeding are disproportionately low and their transition to parenthood is often unlike that of older mothers. Literature to date, however, offers limited evidence for designing effective interventions. Therefore, we aimed to fill this gap in the literature by examining breastfeeding behaviors among a cohort of female adolescents as they transition to parenthood. Data were derived from a longitudinal cohort of pregnant adolescent females (ages 14-21 years) and their male partners, observed from pregnancy through 6 months postpartum. Means and frequencies were used to describe breastfeeding experiences, breastfeeding behaviors, and sociodemographic characteristics. We used multivariate logistic regression and Cox proportional hazards models to identify factors independently associated with breastfeeding initiation, exclusive breastfeeding, and breastfeeding duration. Approximately 71% initiated breastfeeding. Intending to breastfeed, having had complications in labor and delivery, and lower social support were associated with greater odds of breastfeeding initiation. Of the adolescent mothers who initiated breastfeeding, 84% had stopped by 6 months postpartum; among those, average breastfeeding duration was 5 weeks. Participants who exclusively breastfed had longer breastfeeding duration, and participants who had experienced intimate partner violence had shorter breastfeeding duration. Obese women and women who had more difficulty breastfeeding had lower odds of exclusive breastfeeding. Enhanced clinical support and the promotion of exclusive breastfeeding should be considered when designing interventions to improve breastfeeding rates among adolescent mothers.

Assessment of maternal anemia in rural Western China between 2001 and 2005: a two-level logistic regression approach.

BackgroundThere are multiple adverse effects of anemia on human function, particularly on women. However, few researches are conducted on women anemia in rural Western China. This study mainly aims to investigate the levels and associated factors of maternal anemia between 2001 and 2005 in this region.Methods6172 and 5372 mothers with children under three years old were selected from 8 provinces in 2001 and from 9 provinces in 2005 respectively in Western China by means of a multi-stage probability proportion to size sampling method (PPS). The blood samples were tested and related socio-demographic information was obtained through questionnaires. A two-level logistic regression model was employed to identify the determinants and provincial variations of women anemia in 2001 and 2005.ResultsThe results indicated that the crude prevalence of women anemia in 2005 was higher than the rate in 2001(45.7% vs 33.6%). Based on the nationwide census data in 2000, the age-standardized prevalence of women anemia in the study were obtained as 38.0% in 2001 and 50.0% in 2005 respectively. Two-level logistic model analysis showed that compared to the average, women were more likely to be anemic in Guangxi and Qinghai in 2001 as well as in Chongqing and Qinghai in 2005; that women from Minority groups had higher odds of anemia in contrast with Han; that women with higher parity, longer breastfeeding duration and higher socioeconomic level had a lower rate of anemia, while age of women was positively associated with anemia. The positive correlation between women anemia and altitude was also observed.ConclusionsThe study demonstrated that the burden of maternal anemia in rural Western China increased considerably between 2001 and 2005. The Chinese government should conduct integrated interventions on anemia of mothers in this region.

Breastfeeding by Chinese Mothers in Australia and China

Breastfeeding practices might be influenced by migration to another country. Although the "healthy migrant effect" is commonly reported in epidemiology, evidence for it in breastfeeding practices is weak. This study aimed to compare the initiation and duration of breastfeeding between Chinese Australian migrants and Chinese mothers in mainland China and test the healthy migrant effect in Chinese Australian migrants in Perth, Western Australia. A survey was undertaken of 239 Chinese mothers living in Perth and 1844 mothers living in Chengdu, Sichuan Province, PR China, with a response rate of 96.7% and 87.8%, respectively. The breastfeeding initiation rate in Chinese Australian mothers (94.1%) was higher than in mothers in China (86.2%, P < .001). Chinese Australian mothers also had a longer breastfeeding duration, greater "full breastfeeding" rate at 6 months, and greater "any breastfeeding" rates at 6 and 12 months. After controlling for potential confounding variables, the results of the binary logistic regression analysis showed that the location of the mother (Australia or China) was associated with breastfeeding practices. Chinese mothers living in Chengdu were less likely to initiate breastfeeding (odds ratio = 0.47, 95% confidence interval, 0.25-0.89) and breastfeed their babies at 12 months (odds ratio = 0.48, 95% confidence interval, 0.33-0.69) than Chinese mothers in Perth. The higher breastfeeding initiation and longer breastfeeding duration by Chinese migrant mothers in Perth than mothers in Chengdu suggest a "healthy migrant effect."

Association between parity and breastfeeding with maternal high blood pressure

The objective of this study was to determine how parity and breastfeeding were associated with maternal high blood pressure, and how age modifies this association. Baseline data for 74,785 women were sourced from the 45 and Up Study, Australia. These women were 45 years of age or older, had an intact uterus, and had not been diagnosed with high blood pressure before pregnancy. Odds ratios (ORs) and 99% confidence intervals (CIs) for the association between giving birth, breastfeeding, lifetime breastfeeding duration, and average breastfeeding per child with high blood pressure were estimated using logistic regression. The combination of parity and breastfeeding was associated with lower odds of having high blood pressure (adjusted OR, 0.89; 99% CI, 0.82-0.97; P < .001), compared with nulliparous women, whereas there was no significant difference between mothers who did not breastfeed and nulliparous women (adjusted OR, 1.06; 99% CI, 0.95-1.18; P = .20). Women who breastfed for longer than 6 months in their lifetime, or greater than 3 months per child, on average, had significantly lower odds of having high blood pressure when compared with parous women who never breastfed. The odds were lower with longer breastfeeding durations and were no longer significant in the majority of women over the age of 64 years. Women should be encouraged to breastfeed for as long as possible and a woman's breastfeeding history should be taken into account when assessing her likelihood of high blood pressure in later life.

High initiation and long duration of breastfeeding despite absence of early skin-to-skin contact in Karen refugees on the Thai-Myanmar border: a mixed methods study

BackgroundEarly skin-to-skin contact (SSC) after birth is recommended as part of the United Nations Children’s Fund (UNICEF) baby friendly health initiative to promote optimum breastfeeding. This paper reports rates of breastfeeding initiation and duration in a low resource environment, where early SSC is not practised, and explores views of pregnant women and midwives surrounding breastfeeding and swaddling.MethodsData from records from a single hospital on the Thai-Myanmar border where refugee women gave birth during a one-year period (2010) were used to determine breastfeeding initiation rates and the time of the first breastfeed, and duration of breastfeeding of the previous alive child in multigravidae. Focus group discussions (FGD) were conducted to obtain information from pregnant women attending antenatal care about their intended or previous duration of breastfeeding and views on breastfeeding. Interviews with local midwives explored reasons for high rates of breastfeeding in this setting and the practice of newborn swaddling.ResultsOf 1404 live births in 2010 in Maela refugee camp there were 982 evaluable mother-newborn pairs, including 80 infants born before 37 weeks gestation. Initiation of breastfeeding within the first hour after birth and exclusive breastfeeding at discharge in term mother-newborn pairs was 91.2% (823/902) and 99.3% (896/902); and before 37 weeks gestation, 48.8% (39/80) and 98.8% (79/80). Reported duration of previous breastfeeding was 19 (range 2 to 72) months.During FGD all primigravidae (n = 17) intended to breastfeed and all multigravidae (n = 33) had previously breastfed; expected or previous duration of feeding was for more than one year or longer. The major theme identified during FGD was breastfeeding is “good”. Women stated their intention to breastfeed with certainty. This certainty was echoed during the interviews with midwifery staff. SSC requires a delay in early swaddling that in Karen people, with animistic beliefs, could risk loss of the spirit of the newborn or attract malevolent spirits.ConclusionsIn a population with a strong culture of breastfeeding and robust breastfeeding practices, high rates of initiation and duration of breastfeeding were found despite a lack of early skin-to-skin contact. Local preferences, traditions and practices that protect, support and maintain high rates of breastfeeding should be promoted.