Mean Duration Of Breastfeeding Research Articles

Impact of breastfeeding duration on coagulation in women with and without history of gestational diabetes mellitus.

Breastfeeding is associated with a reduced maternal risk for cardiovascular diseases. Since the underlying mechanisms are still poorly understood, we here examined the impact of breastfeeding on the plasmatic coagulation system in women with and without history of gestational diabetes mellitus (GDM). 76 participants of the German Gestational Diabetes Study (PREG; NCT04270578) were examined 14 [interquartile range: 12-26] months after delivery with a 5-point oral glucose tolerance test. Global coagulation tests, prothrombotic coagulation proteins (FII/FVII/FVIII/FIX), antithrombotic proteins (antithrombin, protein C/S) and endothelial markers (von-Willebrand-factor and PAI-1) were determined. The Framingham Risk Score was used to estimate the 10-year cardiovascular risk. The impact of breastfeeding duration on coagulation was analyzed using multivariable linear models. The mean duration of breastfeeding was 11 [7-14] months. Overall, longer duration of breastfeeding was associated with lower cardiovascular risk (Framingham Risk Score, p=0.05) and was negatively associated with FIX (p=0.018). We detected an interaction between previous GDM and breastfeeding duration for FIX (pInteraction=0.017): only in women with GDM history was the duration of breastfeeding negatively associated with FIX activity (p=0.016). This association persisted in statistical models adjusted for age, body-mass index, insulin sensitivity, and C-reactive protein. The duration of breastfeeding was not associated with anticoagulant proteins and endothelial markers. Longer duration of breastfeeding is associated with lower cardiovascular risk and an improved coagulation profile. Women with GDM history appear to benefit particularly from prolonged breastfeeding.

The relationships between optimal infant feeding practices and child development and attained height at age 2 years and 6-7 years.

Limited evidence exists on the long-term effects of early feeding practices on child growth and development. We examined the relationships between infant feeding practices and child height and development at ages 2 and 6-7 years. We studied 885 mother-child dyads from a randomized controlled trial of preconception supplementation in Vietnam. Early initiation of breastfeeding (EIBF), exclusive breastfeeding (EBF), breastfeeding (BF) duration and minimum dietary diversity (MDD) were assessed using World Health Organization(WHO) guidelines. Child development was assessed by the Bayley Scales of Infant Development-III at 2 years and the Wechsler Intelligence Scale for Children®-IV at 6-7years. Child height-for-age z-score (HAZ) was calculated from child height and age. Multivariable regression and structural equation models were used in analyses that controlled for confounding. EIBF and EBF at 6monthsoccurred in 52% and 62% of children, respectively. Mean breastfeeding duration was 18 monthsand 83% achieved MDD at 1year. EIBF was associated with motor (β = 0.13, 95% confidence interval [CI]: 0.00, 0.28) and cognitive development at 2years(β = 0.12, 95%CI: -0.01, 0.26), which in turn were positively associated with cognitive development at 6-7years. EBF was directly associated with development at 6-7years (β = 0.21, 95% CI:0.08, 0.34) whereas motor and cognitive development at 2years explained 41%-75% of the relationship between EIBF and development at 6-7years. HAZ at 2years also mediated 70% of the association between MDD at 1year and HAZ at 6-7years. BF duration was not associated with child development and HAZ. Early infant feeding practices, especially EIBF and EBF, have important long-term implications for optimizing child linear growth and cognition as they begin school.

The investigation of serum phenylalanine levels based on infant feeding method: a cross-sectional study of children less than two years old with phenylketonuria (PKU)

BackgroundClinical advice may suggest discontinuing breastfeeding after the diagnosis of phenylketonuria in infants as the only effective way to monitor the newborn's intake and accurate measurement of phenylalanine (Phe). This study aims to investigate the prevalence and duration of breastfeeding, as well as its effect on serum Phe levels in infants with phenylketonuria at Education and Therapy Medical Center, Be'sat Hospital, Iran.MethodsWe conducted a cross-sectional study of 34 children under two years old diagnosed with phenylketonuria between September 2018 and December 2022. Infants were categorized as breastfed and non-breastfed (bottle-fed) based on their feeding method after diagnosis. Data on age at diagnosis, medical records, demographic information, and anthropometric indices were collected, and infants with incomplete data or mixed feeding (formula + breast milk) were excluded from the study.ResultsOf 94 infants managed in our hospital, 34 had complete medical records. Among the all patients 13 (38%) continued to be breastfed combined with phenylalanine-free amino acid-based protein substitute, while 21 (62%) were did not receive breast milk. The mean duration of breastfeeding was 2.57 ± 0.59 (1–3) months. The mean age at diagnosis was 22.6 ± 18.4 days. Phenylalanine concentrations at diagnosis were mean 10, SD 5.44; range 4–24 mg/dL [0.22–1.33 μmol/L] in the breastfed group and mean 14.3, SD 10.2; range 5–37 mg/dL [0.27–2.05 μmol/L] in the non-breastfed group.Non-breastfed infants had lower serum Phe levels than breastfed infants: mean 3.76, SD 2.10; range 1–7 mg/dL [0.05–0.38 μmol/L] and mean 4.89, SD 3.68; range 2–19 mg/dL [0.11–1.05 μmol/L], respectively, although not statistically significant [(t (34) = 118.0, P = 0.51]. Also we found no significant associations in body measurements for weight, height, and head circumference at birth and final assessment.ConclusionsIn conclusion, during treatment, there were no statistically significant associations between breastfeeding and serum Phe levels with growth in children with phenylketonuria.

Breastfeeding initiation and duration among people with mild chronic hypertension: a secondary analysis of the Chronic Hypertension and Pregnancy trial

Increased duration of breastfeeding improves maternal cardiovascular health and may be especially beneficial in high-risk populations, such as those with chronic hypertension. Others have shown that individuals with hypertension are less likely to breastfeed, and there has been limited research aimed at supporting breastfeeding goals in this population. The impact of perinatal blood pressure control on breastfeeding outcomes among people with chronic hypertension is unknown. This study aimed to evaluate whether breastfeeding initiation and short-term duration assessed at the postpartum clinic visit differed according to perinatal blood pressure treatment strategy (targeting blood pressure <140/90 mm Hg vs reserving antihypertensive treatment for blood pressure ≥160/105 mm Hg). We performed a secondary analysis of the Chronic Hypertension and Pregnancy trial. This was an open-label, multicenter, randomized trial where pregnant participants with mild chronic hypertension were randomized to receive antihypertensive medications with goal blood pressure <140/90 mm Hg (active treatment) or deferredtreatment until blood pressure ≥160/105 mm Hg (control). The primary outcome was initiation and duration of breastfeeding, assessed at the postpartum clinic visit. We performed bivariate analyses and log-binomial and cumulative logit regression models, adjusting models for variables that were unbalanced in bivariate analyses. We performed additional analyses to explore the relationship between breastfeeding duration and blood pressure measurements at the postpartum visit. Of the 2408 participants from the Chronic Hypertension and Pregnancy trial, 1444 (60%) attended the postpartum study visit and provided breastfeeding information. Participants in the active treatment group had different body mass index class distribution and earlier gestational age at enrollment, and (by design) were more often discharged on antihypertensives. Breastfeeding outcomes did not differ significantly by treatment group. In the active and control treatment groups, 563 (77.5%) and 561 (78.1%) initiated breastfeeding, and mean durations of breastfeeding were 6.5±2.3and 6.3±2.1weeks, respectively. The probability of ever breastfeeding (adjusted relative risk, 0.99; 95% confidence interval, 0.93-1.05), current breastfeeding at postpartum visit (adjusted relative risk, 1.01; 95% confidence interval, 0.94-1.10), and weeks of breastfeeding (adjusted odds ratio, 0.87; 95% confidence interval, 0.68-1.12) did not differ by treatment group. Increased duration (≥2 vs <2 weeks) of breastfeeding was associated with slightly lower blood pressure measurements at the postpartum visit, but these differences were not significant in adjusted models. In a secondary analysis of the cohort of Chronic Hypertension and Pregnancy trial participants who attended the postpartum study visit and provided breastfeeding information (60% of original trial participants), breastfeeding outcomes did not differ significantly by treatment group. This suggests that maintaining goal blood pressure <140/90 mm Hg throughout the perinatal period is associated with neither harm nor benefit for short-term breastfeeding goals. Further study is needed to understand long-term breastfeeding outcomes among individuals with chronic hypertension and how to support this population in achieving their breastfeeding goals.

Impact of Maternal Education on Breast Feeding and Complementary Feeding Practices of Infants

Objectives: To determine the impact of maternal education on incidence of breast feeding, duration and infant complementary feeding practices.&#x0D; Methodology: A Cross sectional study done in Department of Paediatric medicine, University of Lahore Teaching Hospital ,Lahore from October 2020 to March 2021. Non probability consecutive sampling technique, total 198 mothers having child 6 to 12 months were enrolled in study after approval of hospital ethical committee and informed consent from mother. Data was entered and analyzed using SPPS 22.&#x0D; Results: Breast feeding was adopted by 62.8% mothers. Mean duration of breast feeding was 8.52±3.1 months. Regarding initiation of breast feeding 35.1% started immediately after delivery. Regarding introduction of solid feed 27.3% started before 6 months of age. Pre lacteal was given in 35.5% infants. There was no impact of maternal education on frequency of breast feeding, p-value 0.328 but duration of breast-feeding was longer in mother having graduation as compared to mothers having education less than matric i.e. 8.77±2.977 months vs 7.82±3.384 months.&#x0D; Conclusion: Mothers with higher education have greater duration of breast-feeding ad compared to mother with less education.

ODP377 Adolescents With Obesity Breastfed Until Four Months Age Have High Abundance Of Ruminococcaceae Bacteria In Gut Microbiota

Abstract Childhood obesity is a worldwide serious health issue leading to endocrine disruption. Childhood obesity risk factors are numerous, and in recent decades the significant impact of gut microbiota in the development of obesity has been shown (1). In turn, gut microbiota development can be disrupted by many factors in the early postnatal period, particularly by breastfeeding duration. Although studies were pointing out the impact of short breastfeeding period on the obesity-associated microbiota formation in childhood (2), the long-termed effect still remains poorly explored. Therefore, we assumed a contribution of breastfeeding duration to the gut microbiota composition in adolescents with obesity. The total cohort was 40 adolescents who were divided into four categories: 9 obese and 11 healthy adolescents who had been breastfed less than four months (SDS BMI=2.83±0.40 and SDS BMI=-0.17±0.55 correspondingly); 9 obese and 11 healthy adolescents who had been breastfed more than four months (SDS BMI=2.70±0.69 and SDS BMI=0.19±0.38). The mean breastfeeding duration was significantly different between the four groups (p=0. 0001). The metagenome sequencing of V3-V4 variable regions of 16S rRNA was done by Novogene Company (China) on the Illumina platform. Bacteria number of gut microbiota was presented as normalized values. Data was shown as median, lower and upper quartile, and compared by the pairwise Mann-Whitney U Test. Statistical significance was accepted at p&amp;lt;0. 05. The Shannon and Simpson diversity indices as well as the ACE and Chao species richness indices of the adolescents’ gut microbiota were not differed for each group. We did not find any significant variations for the main phyla Firmicutes, Bacteroidetes, Proteobacteria, and Actinobacteria. At the family level, the U Test indicated a significant increase in the abundance of the phylotype Ruminococcaceae UCG-014 in adolescents with obesity who were breastfed for four months or less as compared to the group with obesity and breastfeeding more than four months (365 (137; 499) and 99 (72; 149) correspondingly,р=0. 01, Z adjusted=-2.43). Moreover, adolescents with normal weight regardless of breastfeeding duration had similar amount of RuminococcaceaeUCG-014 as adolescents who were breastfed until four months and having obesity (145 (110; 381) for the group with normal weight and breastfeeding&amp;lt;4 months and 154 (96; 245) for the group with normal weight and breastfeeding &amp;gt; 4 months). The family Ruminococcaceae belongs to the phylum Firmicutes, which was proved before as a phylum increasing in gut microbiota of individuals with obesity (1). Our results confirmed that and furthermore, revealed the impact of short overall breastfeeding duration on the gut microbiota composition through an increased abundance of bacteria belonging to the family Ruminococcaceaein adolescents with obesity. Reference: (1) Turnbaugh et al. Nature. 2006 Dec 21;444(7122): 1027-31. (2) Forbes et al. JAMA Pediatr. 2018 Jul 2;172(7): e181161. Presentation: No date and time listed

From Undetectable Equals Untransmittable (U=U) to Breastfeeding: Is the Jump Short?

Background: Vertical transmission of HIV infection may occur during pregnancy, at childbirth or through breastfeeding. Recommendations on the safety of breastfeeding of HIV-infected women on effective antiretroviral treatment are not univocal among international guidelines (WHO 2010, EACS 2017, DHHS 2017), leaving space for variability at the patient’s level. Methods: We collected clinical, laboratory and outcome data from 13 HIV-infected pregnant women who, between March 2017 and June 2021, elected to breastfeed their children against specific medical advice. All mothers were on antiretroviral therapy with darunavir or raltegravir plus emtricitabine/tenofovir disoproxil and remained HIV-RNA undetectable and >400 cells/mmc CD4+ lymphocytes during pregnancy and breastfeeding. Prophylactic antiretroviral therapy (zidovudine for 4 weeks) was started immediately after birth in all newborns. The mean duration of breastfeeding was 5.4 months. Newborns were tested for HIV-RNA multiple times: at birth, 1, 3, and 6 months after birth, and 1, 3 and 6 months after the end of breastfeeding. Results: None of the infants were infected by HIV. Conclusions: Our experience, gathered in the setting of freedom of choice on the patient’s side, while insufficient to address the eventual safety of breastfeeding in HIV-infected mothers since the represented cohort is numerically irrelevant, supports the extension of the U=U (Undetectable Equals Untransmittable) paradigm to this setting. Since breastfeeding is often requested by women with HIV planning pregnancy, more extensive comparative studies should be performed.

Complementary and alternative methods of increasing breast milk of mothers of children aged 0-24 months

Introduction and aim. Some applications are made to increase the breast milk. This study has been conducted to determine the complementary and alternative methods to increase the breast milk of mothers with a child in the age of 0 to 24 months. Material and methods. This study was conducted using the cross-sectional study design. The questionnaire included mothers’ socio-demographic characteristics, obstetric histories, breastfeeding, and practices to increase breast milk. Results. The mean age of the mothers was 29.75±}5.97 years. 23.4% of the mothers stated that they did not continue breastfeeding; the mean duration of breastfeeding was 9.24±}4.88 months. Mothers expressed to increase milk intake water/liquid food to increase (84.2%), frequently breastfed babies (43.3%), boiling greens to drink (34.6%), spiritual practices (12.8%). Mothers stated that the special drinks used to increase their milk were fennel (56.2%), instant milk enhancer (22.9%), and sage (8.9%). Mothers emphasized that the amount of water (85.1%) and sugar levels (50.0%) they consumed the most increased breast milk. Conclusion. It was determined that children could not have enough breast milk until the age of two; the mean duration of breastfeeding was low. Mothers believe that their breast milk is not enough for their children, so they apply milk-increasing practices.

Evaluation of Breastfeeding in 6-24 Month Children in South of Iran

Background and aims: The World Health Organization (WHO) and the United Nations International Children’s Fund have recommended that breastfeeding be continued until two years of age or over. This study aimed to investigate the duration of breastfeeding and weaning in children aged 6-24 months in south of Iran. Methods: This cross-sectional study was conducted in 2017 on 1653 children aged 6-24 months in Fars province of Iran. A multi-stage sampling was used and the data were obtained using a questionnaire including questions about breastfeeding and some related factors, as well as demographic questions about the children and their parents. The required information was collected by visiting and interviewing those mothers who had children aged 6-24 months in their homes. Data were evaluated using SPSS software (version 20.0) and performing descriptive and analytical statistics such as independent samples t test and one-way ANOVA. Results: On average, the children were breastfed up to 18.64±7.40 months of age and the mean age of initiation of complementary feeding was 5.86±1.04 months. Breastfeeding was stopped for 35.6% of children at the age of 24 months and higher. Mothers having had a normal vaginal delivery had a longer lactation period than mothers who had had cesarean delivery (19.27 and 18.05 months, respectively) (P=0.021). Conclusion: A decrease was observed in the mean duration of breastfeeding in this study compared to that obtained in the previous studies, and this decrease was found to be associated with the increase in the occurrence of cesarean delivery in mothers. Therefore, it was recommended that further comprehensive investigations be carried out in this regard.

Breastfeeding in Turkey: A Systematic Review

Objective: This study was carried out to systematically review the studies conducted on breastfeeding in Turkey and to provide information on&#x0D; the breastfeeding status.&#x0D; Methods: This study is a systematic review and conducted by examining 47 studies carried out in Turkey between January 2008-December 2018 and published in national and international journals. The methodological quality of the studies was examined according to the evaluation criteria of the Joanna Briggs Institute Critical Appraisal Checklist for Studies Reporting Prevalence Data. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist was used while reporting the review.&#x0D; Results: According to the obtained study results, it was determined that the time of breastfeeding initiation and the mean duration of breastfeeding were in quite a wide range. Among breastfeeding-related factors, maternal age, education, employment status, the number of living children, the type of birth, preterm birth, receiving professional support on breastfeeding, early postnatal breastfeeding, and giving complementary feeding or formula were frequently listed. The most common reason for starting complementary feeding or was determined to be the idea that breast milk was insufficient.&#x0D; Conclusion: No common language and unity of definition were observed in the studies reviewed. The studies were conducted in different samples. It is thought that the systematization of studies on breastfeeding will be scientifically useful for determining the current situation, determining the scope of future studies, and making the necessary arrangements.

Duration of breastfeeding, age at introduction of complementary foods and allergy-related diseases: a prospective cohort study

BackgroundThe influences of breastfeeding and infant diet in the prevention of allergy-related diseases are uncertain and many of the studies conducted on the topic are limited by methodological challenges. Our aim was to assess whether the duration of breastfeeding and age at complementary food introduction affected the prevalence of asthma, wheeze, allergic rhinoconjunctivitis (ARC) and eczema at two and six years of age.MethodsWe used information gathered between 2000 and 2014 through questionnaires in the Prevention of Allergy among Children in Trondheim (PACT) study, a prospective cohort study in Trondheim, Norway. The current study includes 6802 children who submitted questionnaires detailing breastfeeding duration and or age at introduction to complementary foods, as well as at least one of the child health questionnaires completed at two and six years of age. Adjusted odds ratios (aORs) were calculated for each combination of exposure and outcomes and sensitivity analyses were performed to assess the possible influence of recall bias and reverse causality.ResultsThe mean duration of breastfeeding was 11 months (SD 5.6) in this study population and 5695 of 6796 (84%) infants had been breastfed for at least 6 months. We did not find any conclusive preventative effect of longer breastfeeding on parental reported doctor-diagnosed asthma, aOR 0.79 (95% CI 0.51, 1.21). However, at 6 years of age we observed a reduction in the less strictly defined outcome wheeze, aOR 0.71 (95% CI 0.53, 0.95). Longer breastfeeding was associated with a reduced risk of ARC at 2 years, aOR 0.65 (95% CI 0.49, 0.86), with a continued protective trend at 6 years, aOR 0.77 (95% CI 0.58, 1.04).ConclusionsLonger breastfeeding resulted in a reduced risk of wheeze and a trend towards a protective effect on ARC up until school age. No conclusive associations were seen between the duration of breastfeeding or age at introduction to complementary foods and prevention of asthma, wheeze, ARC and eczema.Trial registrationThe trial is registered in Current Controlled Trials as ISRCTN28090297.

Weaning Practices of Turkish Mothers: A Mixed-Model Research.

Objectives: The aim of this study is to determine the weaning practices of mothers who have children between the ages of 2 and 5 years. Materials and Methods: This study was designed as a cross-sectional descriptive study, which was carried out between September 1, 2019 and October 1, 2019 in a pediatric clinic of a university hospital. For a better understanding, the traditional approaches, qualitative, and quantitative data were collected concurrently and analyzed together using Creswell's concurrent transformative mixed-model research design. Results: Of the 114 participants, the overall mean age was 29.2 ± 4.5 years. The mean breastfeeding duration was 15.3 ± 8.2 months. Sixty five (57.0%) of participants terminated breastfeeding themselves and 55 (85.9%) of them used traditional methods for weaning their children. The traditional methods used for termination of breastfeeding were staining the nipples to make baby startle (16.4%), applying nipples with a bad taste or smell to make baby disgust (40.0%), covering the nipples with various materials (18.2%), using a pacifier or feeding bottle (20.0%), and separation from mother (5.5%). Conclusions: In this study, it was found that most of the Turkish mothers use improper traditional methods for weaning. This study also demonstrated the urgent need to plan effective counseling services to implement natural weaning rather than traditional methods that are unsuitable for weaning.

Breastfeeding duration of different age groups and its associated factors among Chinese women: a cross-sectional study

BackgroundThe current situation of breastfeeding in China has been discussed in many articles, and a declining trend of breastfeeding duration has been confirmed. The associations between various socioeconomic, reproductive factors and breastfeeding duration have been discussed as well. However, there remains a lack of evidence on breastfeeding duration amongst different age groups.MethodsData was extracted from the baseline of a large cohort study: a sample of 300,000 adult women born in the 1930s’ through 1970s’ from 10 geographically distinct regions was obtained. The breastfeeding duration was assumed by breastfeeding duration of the first child. Different age groups were categorized by 10-year age groups, and they were born in 1930–1938, 1939–1948, 1949–1958, 1959–1968, and 1969–1974. Multivariable linear regression was used to evaluate the associations between breastfeeding duration and sociodemographic, and reproductive factors (i.e.: different age groups, education, household size, use of oral contraceptive pills, age at menarche, and age at first birth).ResultsThe mean breastfeeding duration (Standard Deviation) of women born in 1930–1938, 1939–1948, 1949–1958, 1959–1968, and 1969–1974 were 15.4 (9.2), 14.8 (8.2), 14.7 (8.9), 12.8 (7.2), 13.1 (7.2) months, respectively. Younger age groups, higher levels of education, and use of oral contraceptive pills were negatively associated with breastfeeding duration. In particular, the negative association with higher levels of education (for urban regions: βmiddle school = − 1.3, βhigh school & above = − 1.6; for rural regions: βmiddle school = − 0.6, βhigh school & above = − 1.2; all p < 0.0001) was found significant in both rural and urban areas, household size (β = − 0.1, p < 0.0001) and age at first birth (β = − 0.2, p < 0.0001) were negatively associated with breastfeeding duration only in urban areas, but were all positively associated with breastfeeding duration in rural areas.ConclusionsThis research demonstrated that, among Chinese women, younger age groups and higher levels of education were negatively associated with breastfeeding duration. Considering the declining trend of breastfeeding duration in China, healthcare providers need to continue advocating for breastfeeding practices. We also call for collaboration with various sectors and concerned groups to actions that promote breastfeeding-friendly environment and measures.

PROTECTIVE ROLE OF BREASTFEEDING IN CHILDREN WITH CELIAC DISEASE.

Background; The prevalence of thyroid disease is likely increased among chidren with celiac disease (CD). In addition, exposure to gluten-free treatment may be associated with a risk of thyroid disease, but this association remains controversial. Objective; To Determine the frequency of Prolonged breastfeeding in children with celiac disease at a tertiary care hospital. Material and Methods; Children with celiac disease (as given in operational definition) were enrolled and their mothers was inquired regarding history of breastfeeding in their child. All the data was entered and analyzed using SPSS-18. Results; Of these 160 study cases, 67 (41.9 %) were male patients while 93 (58.1 %) were female patients. Mean age of our study cases was 51.19 ± 11.25 months (with minimum age of our study cases was 12 months while maximum age was 60 months). Of these 160 study cases, 92 (57.5 %) belonged to rural areas and 68 (42.5 %) belonged to urban areas. Monthly family income up to Rs. 35000 was noted in 68 (42.5%) while more than Rs. 35000 was noted in 92 (57.5%) of our study cases. Mean disease duration of celiac disease was 5.23 ± 4.21 months and 117 (73.1%) had disease duration up to 6 months. Mean duration of breastfeeding was 18.23 ± 5.43 months and prolonged breastfeeding was noted in 124 (77.5%). Conclusion; Prolonged breastfeeding frequency was poor in children with celiac disease in our study. Prolonged breastfeeding was significantly associated with age, disease duration, ethnicity and maternal literacy. A mass campaign to create awareness regarding benefits of breastfeeding should be launched at national electronic and print media. Clinicians treating children having celiac disease should educate the mothers for breastfeeding benefits so as to decrease disease morbidity which will save them future hardships and improve quality of life of such patients. Keywords; Celiac Disease, Breastfeeding, Prolonged. DOI : 10.7176/JMPB/54-19 Publication date : April 30 th 2019

Practice of Breastfeeding and its Barriers among Women Working in Tertiary Level Hospitals

Breastfeeding provides ideal food for newborns and prevents recurrent infection and malnutrition in infants. In Nepal, breastfeeding is a universal practice but exclusive breastfeeding is low. As there is increased involvement of women in workforce, practice of breastfeeding may have been compromised. The main objective of the study was to examine the practice and barriers of breastfeeding among women working in tertiary level hospitals of Nepal. This was a hospital based descriptive cross-sectional study. Study participants were women working in Dhulikhel Hospital and Kathmandu Medical College and Teaching Hospital and was conducted from December 2017 to June 2018. Ethical approval was taken from institutional review committee of both institutions. Total of 208 women were included in the study and face to face interview was conducted. Data entry and analysis was done using statistical package of social sciences. Breastfeeding practice was universal and colostrum was fed by 195 (94%) women. Pre-lacteal feeding was given by 14 (7%) women and 119 (57%) initiated breastfeeding within one hour of birth. Total of 93 (45%) children were exclusively breastfed for any duration while 10 (11%) were exclusively breastfed for six months. The mean duration of breastfeeding was 14.57 months and 90 (43%) started complementary feeding before six months. Total of 97 (51%) women and 42 (47%) women stated work as barrier for not exclusively breastfeeding and early complementary feeding respectively. Exclusive breastfeeding was very low and children were breastfed for less than two years. Complementary feeding was also started earlier and work was stated as the main barrier for poor breastfeeding practice.

The Influence of Ethnicity on Exclusively Breast-Fed Infants’ Anthropometry in a Multiethnic Asian Population

We studied the effects of ethnicity on early infant growth patterns in exclusively breast-fed (EBF) infants from a Singaporean multiethnic population. This was a prospective cohort study conducted in National University Hospital, Singapore. Healthy, EBF infants born at-term completing 37 weeks and above, and whose birthweight was appropriate for gestational age (>10th centile, <90th centile) were recruited. Infants were required to be EBF at least until the minimum age of weaning. All infants who were preterm and premature, formula-fed, required Intensive/High Dependency care, or born with major congenital anomalies were excluded. A multivariable linear regression analysis was conducted at 5 predetermined time-points (birth; 4-8 weeks; 3-4, 5-8, 12 months) to study the effects of antenatal/parental factors on infant growth. A total of 213 infants were recruited. Maternal age, height and body mass index positively influenced birthweights while maternal hypertension and paternal smoking negatively influenced birthweights. Mean duration of breastfeeding was 8.9 months. Chinese ethnicity did not influence birth anthropometry, but was the single consistent factor that significantly increased weight and length Z-scores from 4-8 weeks until 8 months of life. Chinese ethnicity did not influence head growth throughout the first year of life. EBF Chinese infants have increased weights and lengths compared to non-Chinese infants until 8 months' age, despite similar birth anthropometry. This period of discrepant growth coincides with the average duration of breastfeeding. We hypothesise that ethnic variations in breast milk macronutrient composition influence early somatic growth in infants.

The Association of Breastfeeding Duration and Early Childhood Cardiometabolic Risk

To evaluate the association between breastfeeding duration and early childhood cardiometabolic risk. A cross-sectional study of 1539 healthy children, 3-6 years of age, recruited through The Applied Research Group for Kids! practice-based research network between October 2009 and August 2015. Adjusted multivariable linear regression was used to examine the association between breastfeeding duration and cardiometabolic risk z score and individual cardiometabolic risk factors of waist circumference, systolic blood pressure, glucose, high-density lipoprotein cholesterol, and triglycerides. The mean breastfeeding duration was 12.5 months (SD = 8.4). Breastfeeding duration was associated with lower cardiometabolic risk z score (beta = -0.03; 95% CI -0.05, -0.01). In analysis of cardiometabolic risk factors, each additional 3 months of breastfeeding was associated with a 0.13 cm (95% CI -0.20, -0.05) lower waist circumference and 0.16 mm Hg (95% CI -0.30, -0.02) lower systolic blood pressure. Compared with children who breastfed for 6-12 months, those who breastfed for 12-24 months had a lower systolic blood pressure of 1.07 mm Hg (95% CI -2.04, -0.10). There was no association between breastfeeding duration and cardiometabolic risk for those who breastfed beyond 24 months. Breastfeeding duration is associated with lower cardiometabolic risk, although the magnitude of association is small. Causation cannot be inferred. Breastfeeding beyond 24 months may not have an added benefit for cardiometabolic health.

Socioeconomic status and breastfeeding in China: an analysis of data from a longitudinal nationwide household survey

BackgroundThe benefits of breastfeeding, to infant and mother, are supported by a comprehensive body of evidence. However, in China, only a small proportion of women achieve the breastfeeding recommendation from WHO. Previous studies in high-income countries have found a positive association between socioeconomic status and initiation and duration of breastfeeding. This association might differ between societies and be affected by rapid social and economic development, such as has occurred in China over the past decade. The purpose of this study was to investigate the role of socioeconomic status on breastfeeding initiation and duration in China. MethodsIn this analysis we used data from the China Family Panel Studies (CFPS), funded by the 985 Program of Peking University and undertaken by the Institute of Social Science Survey of Peking University. CFPS is a nationally representative and longitudinal household survey that has been collecting individual, family, and community information annually in China since 2010. CFPS has surveyed 15 000 selected households in 25 provinces or directly governed municipalities. Our analysis included all surveyed children who were born between 2010 and 2014, and excluded children with missing breastfeeding information. We obtained data for initiation of breastfeeding (ie, breastfed or non-breastfed), and duration of breastfeeding time, expressed in months. Socioeconomic status was measured using household income per capita, parental years of education, and parental occupational status. We used Kaplan-Meier time-to-event analysis to compare duration of breastfeeding according to socioeconomic status variables, a logistic regression model to analyse the association between socioeconomic status and initiation of breastfeeding, and a Cox proportional hazards model to analyse breastfeeding duration and socioeconomic status. Sex of infant, birthweight of infant, birthplace, nationality, type of residence, age of parents, residential region, marriage status of mother, parity of mother, and birth year were adjusted for in the logistic and Cox model. CFPS was undertaken according to the guidelines laid down in the Declaration of Helsinki and all procedures involving human participants were approved by the ethics committee of Peking University. Written informed consent was obtained from all participants. FindingsOur sample consisted of 2938 children. 2658 (90%) infants had ever breast-fed, and the mean duration of breastfeeding was 8·66 months (SD 6·15). After adjusting for potential confounders, we found that socioeconomic status variables were not significant predictors for breastfeeding initiation, but that low birthweight babies were less likely to be breastfed than normal weight babies (odds ratio 0·272, 95% CI 0·18–0·42; p<0·0001). As for breastfeeding duration, mothers with a high school or higher education were more likely to breastfeed for longer than those with a middle school or lower education (hazard ratio [HR] 1·15, 95% CI 1·02–1·29; p=0·021), as were infants with fathers with the highest occupation level versus those with fathers with the lowest occupation level (HR 1·29, 95% CI 1·04–1·59, p=0·019). Mother's occupation had an inverted U-shaped relationship with breastfeeding duration (HRs for low, high, and highest occupation level vs lowest occupation level were 1·17 [95% CI 1·02–1·33], p=0·023; 1·29 [1·08–1·54], p=0·005; and 1·11 [0·87–1·42], p=0·408, respectively). InterpretationThe finding that socioeconomic status in China was not a predictor of breastfeeding initiation is different from that reported in high-income countries. Comprehensive efforts to promote breastfeeding practices should be targeted towards women who are less well educated, and those in both the lowest and highest occupation levels, because we found that these variables were associated with shorter breastfeeding duration. FundingSichuan University (skqx201401 and 2015SCU04A19).

The Effects of Breastfeeding in Infants With Phenylketonuria

PurposeIn the early years of phenylketonuria (PKU) treatment, mothers and healthcare professionals often decide to discontinue breastfeeding after the diagnosis of PKU in infants. It was believed to be the only effective way to monitor the infant's intake and allow for precise titration and measurement of the intake of phenylalanine (Phe). In the early 1980s, with the determination of low concentration of Phe in breast milk, breast milk supplemented with Phe-free formula has become an acceptable dietary treatment for infants with PKU. Today, breastfeeding is encouraged and well established in PKU patients.The aim of the present study is to investigate the prevalence and duration of breastfeeding, the effect of breastfeeding on serum Phe levels, and weight gain in infants with PKU. Design and MethodsData were collected from chart reviews. Medical records of 142 children with PKU diagnosed via the national neonatal screening program were analyzed retrospectively. ResultsOf the 41 infants with complete medical records, 40 (97.6%) were breastfed following delivery whereas only one (2.4%) was bottle fed. After the diagnosis, breastfeeding was continued in 25 (61%) infants with phenylalanine-free amino acid based protein substitute. The mean duration of breastfeeding was 7.4±4.0 (1–15) months. Serum Phe concentration of breastfed infants (280±163 μmol/L) was significantly lower than non-breastfed infants (490±199 μmol/L) (p<0.001). Mean monthly weight gain in the first year of life was significantly higher in breastfed patients (493±159 g/month) compared to non-breastfed patients (399±116 g/month) (p=0.046). ConclusionIn the first year of life, weight gain and serum Phe levels were more favorable in breastfed infants with PKU compared to non-breastfed infants with PKU.

The Effect of Preoperative Oral Carbohydrate on Breastfeeding After Cesarean Section: A Double-Blind, Randomized Controlled Clinical Trial

ABSTRACTDelay in the initiation of breastfeeding is one of the problems of cesarean section. Its causes are insulin resistance, pain, anxiety, stress, thirst, hunger, and so on. Preoperative oral carbohydrate (OCH) reduces postoperative insulin resistance and improves postoperative recovery. The present study was conducted to evaluate the effect of preoperative oral carbohydrate on breastfeeding after cesarean section. In this double-blind randomized clinical trial, 91 pregnant women who underwent elective cesarean section were randomly assigned to preoperative OCH (Nutricia Preop; n = 45) or control group (water flavored with lemon; n = 46). The patients ingested 800 ml + 400 ml of liquid before the surgery. The time to first breastfeeding after surgery (min), the duration of breastfeeding (min), and breastfeeding frequency were measured using a questionnaire for up to 36 h after the surgery. Time to first breastfeeding after surgery was significantly shorter in the OCH group than in the control group (27.47 ± 11.51 vs. 51.96 ± 20.20 min, p< .001). The mean frequency of breastfeeding (6.14 ± 0.55 vs. 4.82 ± 0.46, p < .001) was significantly higher and the mean duration of breastfeeding (116.48 ± 19.68 vs. 82.13 ± 12.40 min, p < .001) was significantly longer in the OCH group compared with the control group in the first 36 h after the surgery. Preoperative oral carbohydrate improves breastfeeding after surgery (time to first breastfeeding, breastfeeding frequency, and breastfeeding duration). Further clinical trials and precise measurement tools are needed to assess breastfeeding to confirm these effects. The study was registered at http://www.IRCT.ir (IRCT2016072629082N1).