Median Duration Of Breastfeeding Research Articles

Breastfeeding and maternal eating behaviours are associated with child eating behaviours: findings from the ROLO Kids Study

BackgroundChild eating behaviours can negatively contribute to the development of childhood obesity. This study investigated associations between breastfeeding habits, maternal eating behaviours and child eating behaviours, in 5-year-old children.MethodsSecundigravida women were recruited to the ROLO dietary randomised controlled trial (Dublin, Ireland) and were followed up with their children to 5 years of age. Breastfeeding exposure and duration were obtained at postnatal and infant follow-up at 2 and 6 months and 2 and 5 years. At 5 years, maternal and child eating behaviours were measured using the Three Factor Eating Questionnaire and the Child Eating Behaviour Questionnaire, respectively. Regression determined associations between breastfeeding habits and maternal eating behaviours with child eating behaviours, controlling for RCT group, maternal education level, maternal BMI at 5 years, childcare exposure and child BMI centile at 5-year follow-up.ResultsThere were 230 mother and child pairs analysed. One hundred and fifty-eight mothers had initiated breastfeeding. Median breastfeeding duration was 22 (IQR 33) weeks. Children who were never breastfed were more likely to express a desire to drink (B = −1.01, p = 0.022). Longer breastfeeding duration was associated with lower food responsiveness (B = −1.71, p = 0.003). Maternal uncontrolled eating was positively associated with child food responsiveness, emotional overeating and emotional undereating (B = 0.21, p < 0.001; B = 0.14, p = 0.005; B = 0.14, p = 0.005, respectively). Maternal emotional eating was associated with child emotional overeating and undereating (B = 0.27, p < 0.001, B = 0.29, p = 0.004, respectively).ConclusionNot breastfeeding and short breastfeeding duration may contribute to the development of obesogenic eating behaviours in children, alongside maternal eating behaviours including uncontrolled and emotional eating. These ‘food approach’ eating behaviours may increase risk of overweight/obesity as they are associated with increased energy intake, hence the importance of research surrounding eating behaviours.

Breastfeeding Practices among Mothers in Southwest Nigeria

This study was conducted to determine the breastfeeding practices among parous antenatal attendees in two teaching hospitals in Southwest Nigeria. A cross-sectional study was carried out on 340 parous antenatal clinic attendees in two teaching hospitals in Ogun State, Nigeria. A structured questionnaire was used to obtain data on breastfeeding practices. Data were analyzed using Statistical Package for Social Sciences (SPSS) windows version 21.0 (IBM Corp., Armonk, NY, USA). Out of a total of 340 women, 319 (93.8%) breastfed their last babies. The median duration of breastfeeding was 15 months. One hundred and thirty two women (38.8%) initiated breastfeeding within 30 minutes of delivery, and 200 women (58.8%) exclusively breastfed their babies for six months. The majority of the women, 299(87.9%k) did not report any problem associated with breastfeeding. Logistic regression analysis showed that women who had no breastfeeding problems were more likely to exclusively breastfeed their infants for six months compared to those with breastfeeding problems (AOR 3.4; CI 1.6-7.1; P=0.001). Similarly, women who got breastfeeding information from mass media were more likely to practice exclusive breastfeeding for six months compared to those that got breastfeeding information from other sources (AOR42.2; CI 3.1-568.5; P=0.005). Exclusive breastfeeding is suboptimal in Ogun State, Nigeria. Provision of breastfeeding information via mass media will assist in improving breastfeeding practice. Educating mothers on the techniques that help to prevent breastfeeding complications will also be beneficial.

Breastfeeding practices among childhood cancer survivors.

This cross-sectional study compared breastfeeding outcomes among childhood cancer survivors to those of women in the general population and evaluated whether breastfeeding is adversely affected by cancer treatment or endocrine-related late effects. A self-reported survey ascertained breastfeeding practices and incorporated items from the questionnaires used in the Infant Feeding Practices Study II (IFPS II) to allow comparison with the general population. Among 710 eligible survivors, 472 (66%) responded. The participants were predominantly non-Hispanic White (84%), married (73%), and had some college or less (60%). The mean maternal age at the time of birth of the first child after cancer treatment was 24years (SD 24.3 ± 4.8). Fewer survivors planned to breastfeed than did IFPS II controls (67% vs. 82%, P < .0001), and fewer survivors initiated breastfeeding (66% vs. 85%, P < .0001). The median breastfeeding duration was shorter among survivors, with early undesired weaning occurring sooner in the survivor group (1.4months, interquartile range (IQR) 0.5-3.5months) than in the IFPS II group (2.7months, IQR 0.9-5.4months). A higher proportion of survivors reported an unfavorable breastfeeding experience (19% vs. 7.5%, P < .0001) and early, undesired weaning (57.5%, 95% CI 51-64) than did IFPS II participants (45.2%, 95% CI 44-47, P = .0164). Among survivors who expressed intention and chose to breastfeed, 46% endorsed disrupted lactation related to physiologic problems with high risk in those overweight/obese. Survivors are at risk of negative breastfeeding experiences; however, lactation outcomes were not significantly associated with cancer diagnosis, treatments, or endocrine complications. Prior research has not examined the association of cancer treatments and clinically validated late effects with lactation outcomes in a clinically diverse childhood cancer survivor cohort. Findings from this study suggest that childhood cancer survivors, especially those who are overweight/obese, are at risk of having negative breastfeeding experiences. Early undesired weaning, physiologic problems related to lactation and misconceptions about breastfeeding, especially fears of passing on cancer through breastmilk, highlight the need for counseling and specialized support to optimize lactation outcomes in this vulnerable population.

Maternal intention to breastfeed, duration of breastfeeding and reasons for weaning: a cohort study, Pelotas, RS, Brazil, 2014.

to evaluate maternal intention to breastfeed, duration of breastfeeding up to 24 months-of-age and reasons for weaning in the first year of life. this was a cohort study conducted in Pelotas, RS, Brazil, with participants from the Multi-Center Body Composition Study; a life table was used to analyze duration of breastfeeding. of the 1377 mothers screened, 74.3% reported intending to exclusively breastfeed up until 6 months, while 91.1% intended to prolong breastfeeding until at least 12 months; 58.0% of children were breastfed up to at least 6 months; median breastfeeding duration was 10.8 months (IQR: 5.8 - 23.0); the main reasons reported for weaning were insufficient breast milk (57.3%), return to work/school (45.5%), and unexplained refusal by the baby (40.1%). the results show that despite the intention to breastfeed, there are still structural and social barriers that interfere with successful breastfeeding, especially those related to working mothers.

Trends and factors associated to early initiation of breastfeeding, exclusive breastfeeding and duration of breastfeeding in Ethiopia: evidence from the Ethiopia Demographic and Health Survey 2016

BackgroundInitiation of breastfeeding immediately after birth, exclusive breastfeeding, and continuous breastfeeding for at least 2 years lower the risk of newborn deaths. This study was conducted to examine the trends and factors associated with early initiation of breastfeeding, exclusive breastfeeding and duration of breastfeeding in Ethiopia.MethodsData for this study were extracted from the Ethiopian Demographic and Health Survey 2016. A total of 5122 children were included in the analysis. Multivariate logistic regression analysis, and Cox proportional hazards model were fitted to find the factors associated with breastfeeding practices. Reported p - values < 0.05 or a 95% Confidence Interval of Odds Ratio/Hazard Ratio excluding one was considered as significant association with early initiation of breastfeeding, exclusive breastfeeding, duration of breastfeeding and independent variables.ResultsAbout 81.8% of the children initiated breastfeeding within 1 h of birth and during the day before an interview, 47% were exclusively breastfed during the first 6 months. The median duration of breastfeeding was 22 months (22 ± 0.50 months 95% Confidence Interval [CI] 21.01–22.99). Rural residents (Odds Ratio [OR] 0.71, 95% CI 0.51, 0.99), mothers with no antenatal follow up (OR 0.75, 95% CI 0.57, 0.99), caesarean birth (OR 0.80, 95% CI 0.66, 0.96) and home delivery were associated with low initiation of breastfeeding within 1 h of birth. Mothers with no/primary education (OR 0.62, 95% CI 0.40, 0.96), no baby postnatal checkup (OR 0.53, 95% CI 0.39, 0.73), average/larger size of a child at birth (OR 0.80, 95% CI 0.65, 0.99) and deliveries outside of health centers were significantly associated with non-exclusive breastfeeding at the time of the interview. Further, mothers living in Amhara (Hazard Ratio [HR] 1.31, 95% CI 1.05, 1.64), Oromia (HR 1.27, 95% CI 1.04, 1.54), and Benishangul-Gumuz (HR 1.34, 95% CI 1.09, 1.65) regions had a longer duration of breastfeeding while Muslims, employed mothers, multiple births and poor economic level of households were associated with shorter durations of breastfeeding.ConclusionsRural residence, female sex, home delivery, caesarean birth, small birthweight baby and large family size were associated with late initiation of breastfeeding. Living in Affar, Somali, and Harari, primary education level of mothers, giving birth outside of health facilities, no antenatal care follow up, and no postnatal check-up were associated with non-exclusive breastfeeding, while younger age mothers, Muslims, giving birth outside of health facilities, and employed mothers were associated with shorter time to cessation of breastfeeding. Providing health education and counseling for mothers during and after pregnancy should be encouraged.

Investigating the Relationship Between Breastfeeding Duration and Health Literacy in Primiparous Women Referring to Tehran Health Centers: An Application of Bayesian Poisson Regression Model

Introduction: Breast milk is an ideal food for the healthy growth and development of infants. Breastfeeding is associated with benefits of lifelong health for both infants and mothers. This study aims to investigate the factors affecting breastfeeding duration in primiparous women referring to Tehran health centers. Methods: In this analytical study, the population consisted of primiparous women of reproductive age who referred to Tehran health centers in 2015-2016 having a child aged 2-5 years. Data were collected by a questionnaire for measuring the level of Health Literacy for Iranian Adults (HELIA) in the urban population, a Socio-Economic Status (SES) questionnaire and interviews with mothers. Statistical analysis was done using Bayesian Poisson regression model and OpenBUGS software. Results: In the present study, the minimum and maximum of breastfeeding duration were one and 24 months respectively, and the median duration of breastfeeding was 20 months. Also, exclusive breastfeeding was reported at 50.5%. The variables age of mother (CI 95%: -0.01, -0.008), health literacy score (CI 95%: 0.01, 0.02) and the first-time breastfeeding more than one hour after birth (CI 95%: -0.34, -0.04) had significant relationship with breastfeeding duration. Conclusion: The health literacy score, the age of mother and the first-time breastfeeding more than one hour after birth had a significant relationship with breastfeeding duration. Therefore, considering the importance of the effect of maternal health literacy on breastfeeding, it is suggested that mothers of prepregnancy have the ability to obtain a high score of health literacy

Breastfeeding During Family Medicine Residency.

Canadian residents' breastfeeding experiences have only been reported in studies that broadly explored pregnancy and parenthood. We sought to fully explore Canadian family medicine resident mothers' breastfeeding experiences, and identify strategies to support workplace breastfeeding for future trainees. Using an online survey, University of Toronto family medicine residents who gave birth from 2010 through 2016 were queried about their exclusive and overall breastfeeding duration, barriers, and facilitators to workplace breastfeeding, and strategies to improve the breastfeeding experience for future resident mothers. Data were downloaded from Qualtrics software and descriptive statistical analyses were conducted using IBM SPSS Statistics v.24.0. Subjective comments were examined and linked to quantitative findings. Fifty-six of 179 eligible residents completed the survey (31% response rate). More than three-quarters of residents were on maternity leave for 7 to 12 months. All initiated breastfeeding, and 54% breastfed exclusively for 6 months. The median breastfeeding duration was 10 to 12 months. Almost two-thirds of residents were breastfeeding upon return to work, and all experienced barriers to workplace breastfeeding including lack of time, private space, and refrigeration for expressed milk. Lack of a workplace breastfeeding policy and inadequate support from supervisors or program directors were additional barriers. Peer mentorship and more breastfeeding education were identified as strategies to support future residents' breastfeeding goals. Addressing long-standing barriers to workplace breastfeeding, and providing peer and educational supports were identified as strategies that could inform program policies to support future trainees' breastfeeding goals and experiences.

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

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

Population Duration of Breastfeeding and Prevalence of Bifidobacterium Longum Subspecies Infantis (OR01-01-19)

ObjectivesLack of microbiota accessible carbohydrates (MAC) can drive gut commensal extinctions. Infant formula lacks the MAC found in breastmilk, human milk oligosaccharides (HMOs). As a result, a switch from breastmilk feeding (high MAC) to formula (low MAC) may drive extinctions of infant gut commensals. MethodsThe prevalence of Bifidobacterium longum subsp. infantis, a bacterium that efficiently consumes HMOs, was compared in cohorts from Austria, Bangladesh, Finland, Gambia, Germany, Switzerland, and United States. Scientific literature reports that both Bangladesh and Gambia have long duration breastfeeding without a history of prevalent formula use; Bangladesh has a mean duration of breastfeeding of 31.9 months and Gambia has a median duration of breastfeeding >18 months. This contrasts with European countries and the US, who all have median duration of breastfeeding <12 months and had a nadir in breastfeeding rates in the 1960 s. Deterministic epidemiological models of B. infantis prevalence were created for each country to explore the potential effect of changing duration of breastfeeding on the prevalence of B. infantis. ResultsThe highest prevalence of infant colonization with B. longum subsp. infantis was observed in countries without a history of disrupted breastfeeding patterns, Bangladesh and Gambia (80% and 91% colonization prevalence, respectively). The remaining countries had a prevalence of infant colonization with B. infantis ranging from 0.7% to 14%. The majority of infants in the European countries had gut communities dominated by Bifidobacterium (>50% relative abundance Bifidobacterium) despite the low frequency of colonization with B. infantis. The R0 of B. infantis transmission varied by country. ConclusionsThe prevalence of infant colonization with B. infantis may be sensitive to breastfeeding duration in populations. Our data supports the concept that lack of MAC drives commensal extinctions, and suggests that deliberate intervention may be needed to restore B. infantis, a bacteria that benefits infant health. More studies are needed, particularly to determine whether species of Bifidobacterium other than B. infantis are sensitive to breastfeeding duration, and to understand the impact of different types of Bifidobacterium on infant health. Funding SourcesNIH awards F32HD093185 (DHT), AT007079 (DAM), and AT008759 (DAM).

Growth trajectories of breastfed HIV-exposed uninfected and HIV-unexposed children under conditions of universal maternal antiretroviral therapy: a prospective study

Over 1 million HIV-exposed uninfected (HEU) children are born in sub-Saharan Africa annually. Little data exist on the risk of impaired growth in this population under current policies of universal maternal antiretroviral therapy (ART) with breastfeeding. We aimed to study the growth of breastfed HEU children born to women who initiated ART during pregnancy and compare their growth with that of breastfed HIV-unexposed (HU) children drawn from the same community. A prospective cohort of HIV-uninfected and HIV-infected pregnant women, who were initiating ART, were enrolled at their first antenatal care visit in a primary care centre in Gugulethu, Cape Town, South Africa. HIV infected women were participants of the Maternal Child Health Antiretroviral Therapy (MCH-ART) study, and HIV-uninfected pregnant women were participants in the HIV-Unexposed-Uninfected (HU2) study. All women were followed up during pregnancy, through delivery, to the early postnatal visit, which was scheduled for the first week after birth. At this visit, eligible breastfeeding mother-child pairs were recruited for continuation of postnatal follow-up until approximately age 12 months. Child anthropometry was measured at around 6 weeks, and every 3 months from month 3 to month 12. Weight-for-age (WAZ), length-for-age (LAZ), weight-for-length (WLZ), head circumference-for-age, and body-mass index-for-age Z scores were compared between HEU and HU children longitudinally using mixed effects linear regression. At 12 months, proportions of HEU and HU children with moderate or severe malnutrition were compared cross-sectionally using logistic regression. MCH-ART is registered with ClinicalTrials.gov, number NCT01933477. Between June, 2013, and April, 2016, 884 breastfeeding mothers and their newborn babies (HEU, n=471; HU, n=413) were enrolled into postnatal follow-up. Excluding 12 children who tested HIV positive during follow-up, 461 HEU and 411 HU children attended 4511 study visits in total, with a median of 6 visits (IQR 5-6) per child. Birth characteristics were similar (overall, 94 [11%] of 872 preterm [<37 weeks] and 90 [10%] small-for-gestational age [birthweight <10th percentile]). Median duration of breastfeeding was shorter among HEU than HU children (3·9 months [IQR 1·4-12·0] vs 9·0 months [IQR 3·0-12·0]). Although WAZ scores increased over time in both groups, HEU children had consistently lower mean WAZ scores than HU children (overall β -0·34, 95% CI -0·47 to -0·21). LAZ scores decreased in both groups after 9 months. At 12 months, HEU children had lower mean LAZ scores than HU children (β -0·43, -0·61 to -0·25), with a higher proportion of children stunted (LAZ score <-2: 35 [10%] of 342 HEU vs 14 [4%] of 342 HU children; odds ratio [OR] 2·67, 95% CI 1·41 to 5·06). Simultaneously, overweight (WLZ score >2) was common in both groups of children at 12 months (54 [16%] of 342 HEU vs 60 [18%] of 340 HU children; OR 0·87, 95% CI 0·58 to 1·31). Compared with HU children, HEU children have small deficits in early growth trajectories under policies of universal maternal ART and breastfeeding. Large proportions of both HEU and HU children were overweight by 12 months, indicating substantial risks for early onset obesity among South African children. Although the longer-term metabolic effects of ART exposure in the context of childhood obesity warrants further investigation, addressing childhood obesity should be an urgent public health priority in this setting. Eunice Kennedy Shriver National Institute of Child Health and Human Development, Elizabeth Glaser Pediatric AIDS Foundation, South African Medical Research Council, and the Fogarty Foundation.

Assessment of breastfeeding knowledge and practices among working mothers in the federal capital territory Nigeria

Background: Inadequate infant feeding practices is a major contributor to the high burden of childhood morbidity and mortality in many countries. Female participation in the labour sector has increased and many of them return to work soon after giving birth posing a significant barrier to breastfeeding. This study assessed the knowledge and practice of breastfeeding among working mothers in the Federal Capital Territory, Nigeria.Methods: This cross-sectional study was done among 360 working mothers selected by multistage sampling technique. Quantitative and qualitative data were collective using interviewer-administered questionnaire and key informant interview guide, respectively. Data was analyzed using Statistical Package for Scientific Solutions (SPSS) version 21.0 and significant level was set at p&lt;0.05.Results: Two hundred and seventy-six (76.7%) of the respondents had good knowledge of breast feeding. More than three-quarters (77.2%) initiated breastfeeding within one hour of birth, 201 (55.8%) practiced exclusive breastfeeding correctly and 201 (55.8%) introduced complementary foods on time. Median duration of breastfeeding was 14.6 months. Less than half of them (41.7%) had good overall practice of breastfeeding. Level of education, sector of work, knowledge of breastfeeding and availability of on-site crèche were significantly associated with practice of breastfeeding. Common barriers to breastfeeding included poor spousal support, no paid maternity leave and non-availability of nearby crèches. Most of the organizations observed had a breast feeding policy.Conclusions: This study revealed a gap between the knowledge and practice of adequate breastfeeding among the respondents and identified some perceived barriers to optimal breastfeeding.

Infant Feeding and Weight Gain: Separating Breast Milk From Breastfeeding and Formula From Food.

Studies addressing breastfeeding and obesity rarely document the method of breast milk feeding, type of supplementation, or feeding in hospital. We investigated these practices in the CHILD birth cohort. Feeding was reported by mothers and documented from hospital records. Weight and BMI z scores (BMIzs) were measured at 12 months. Analyses controlled for maternal BMI and other confounders. Among 2553 mother-infant dyads, 97% initiated breastfeeding, and the median breastfeeding duration was 11.0 months. Most infants (74%) received solids before 6 months. Among "exclusively breastfed" infants, 55% received some expressed breast milk, and 27% briefly received formula in hospital. Compared with exclusive direct breastfeeding at 3 months, all other feeding styles were associated with higher BMIzs: adjusted β: +.12 (95% confidence interval [CI]: .01 to .23) for some expressed milk, +.28 (95% CI: .16 to .39) for partial breastfeeding, and +.45 (95% CI: .30 to .59) for exclusive formula feeding. Brief formula supplementation in hospital did not alter these associations so long as exclusive breastfeeding was established and sustained for at least 3 months. Formula supplementation by 6 months was associated with higher BMIzs (adjusted β: +.25; 95% CI: .13 to .38), whereas supplementation with solid foods was not. Results were similar for weight gain velocity. Breastfeeding is inversely associated with weight gain velocity and BMI. These associations are dose dependent, partially diminished when breast milk is fed from a bottle, and substantially weakened by formula supplementation after the neonatal period.

Breastfeeding self-efficacy and postpartum depression: a cohort study.

ABSTRACTObjective:to evaluate breastfeeding self-efficacy, the presence of postpartum depression symptons and the association between breastfeeding self-efficacy and postpartum depression with cessation of exclusive breastfeeding. Method:cohort study with 83 women. The instruments used were the Breastfeeding Self-Efficacy Scale and the Edinburgh Postnatal Depression Scale. Statistical analysis was conducted using the log-rank tests, analysis of variance and the Cox survival model. Results:breastfeeding self-efficacy (p = 0.315) and postpartum depression (p = 0.0879) did not show any statistical difference over time. The chances of cessation of exclusive breastfeeding decreased by 48% when self-efficacy changed from low to medium and by 80% when it changed from medium to high. Postpartum women who scored ≥10 on the Edinburgh Postnatal Depression Scale interrupt exclusive breastfeeding, on average, 10 days earlier than those with a score ≤9, whose median breastfeeding duration was 38 days postpartum. Conclusion:breastfeeding self-efficacy was proved to be a protective factor for exclusive breastfeeding, while postpartum depression is a risk factor.

Neurodevelopment of breastfed HIV-exposed uninfected and HIV-unexposed children in South Africa.

To assess neurodevelopment of breastfed HIV-exposed uninfected (HEU) and breastfed HIV-unexposed children in the context of universal maternal antiretroviral therapy (ART). Prospective study with antenatal enrolment and follow-up of breastfeeding HEU and HIV-unexposed mother-infant pairs through 12-18 months postpartum. Peri-urban community, Cape Town, South Africa. HEU (n = 215) and HIV-unexposed (n = 306) children. Cognitive, motor and language development at median 13 (interquartile range 12-14) months of age: continuous and dichotomous Bayley Scales of Infant and Toddler Development Third Edition (delay defined as composite score <85). Incidence of preterm delivery (<37 weeks) was similar among HEU and HIV-unexposed children (11 vs. 9%, P = 0.31; median gestation 39 weeks); 48% were boys. Median breastfeeding duration was shorter among HEU vs. HIV-unexposed children (6 vs. 10 months). All HIV-infected mothers initiated lifelong ART (tenofovir-emtricitabine-efavirenz) antenatally. HEU (vs. HIV-unexposed) children had higher odds of cognitive delay [odds ratio (OR) 2.28 (95% confidence interval (CI) 1.13-4.60)] and motor delay [OR 2.10 (95% CI 1.03-4.28)], but not language delay, in crude and adjusted analysis. Preterm delivery modified this relationship for motor development: compared with term HIV-unexposed children, term HEU children had similar odds of delay, preterm HIV-unexposed children had five-fold increased odds of delay (adjusted OR 4.73, 95% CI 1.32; 16.91) and preterm HEU children, 16-fold increased odds of delay (adjusted OR 16.35, 95% CI 5.19; 51.54). Young HEU children may be at increased risk for cognitive and motor delay despite universal maternal ART and breastfeeding; those born preterm may be particularly vulnerable.

Breastfeeding practices among mothers of children aged 1–24 months in Egor Local Government Area of Edo State, Nigeria

Objective: The aim was to determine the breastfeeding practices of mothers of children two years and below in Egor Local Government Area (LGA) of Edo State.Design: This is a community-based descriptive cross-sectional study. Subjects were recruited consecutively by multi-staged sampling technique. A semi-structured researcher-administered questionnaire was used to obtain information from the respondents.Setting: Subjects were from the Edaiken community in Egor LGA State, Nigeria.Subjects: Mother and child pairs were recruited.Outcome measures: The early initiation of breastfeeding rate, prevalence of exclusive breastfeeding and the duration of breastfeeding were calculated from the information obtained from the mothers. Factors associated with the practice of early initiation of breastfeeding and exclusive breastfeeding were also determined.Results: A total of 186 mothers (44.5%) of the 418 recruited initiated breastfeeding (early) within one hour of delivery. The prevalence of exclusive breastfeeding (EBF) was 36.6%. Maternal education was significantly associated with the practice of EBF while maternal age and delivery facility were significantly associated with early initiation of breastfeeding. The median duration of breastfeeding was 15.1 ± 2.3 months.Conclusion: Less than half of the mothers of children aged 1–24 months in Egor LGA practised early initiation of breastfeeding and exclusive breastfeeding. Nutritional education at the community level should be embarked upon by the Local Health Authority of Egor LGA to improve these practices.

Breastfeeding During Infancy Is Associated With a Lower Future Risk of Pediatric Multiple Sclerosis

BackgroundRisk of multiple sclerosis (MS) is influenced by environment and genetics. Infant breastfeeding appears protective against some childhood autoimmune disorders, but its impact on risk of MS in childhood is unknown. The objective of this study is to analyze the association of breastfeeding in infancy on future risk of pediatric-onset MS. Basic ProceduresBiological mothers of 36 consecutive pediatric-onset MS patients completed a questionnaire on history of breastfeeding and various birth and demographic factors. The control group consisted of 72 otherwise healthy patients with a diagnosis of migraine and normal brain magnetic resonance imaging obtained less than 12 months before enrollment. Inverse probability of treatment weighting was used to reduce selection bias and balance the covariates between breastfed and non–breastfed children. Main FindingsDemographics (with the exception of body mass index) and birth factors were not significantly different between groups. Whereas 36% of cases were breastfed, 71% of controls were breastfed (P = 0.001). The median duration of breastfeeding was 0 weeks (range: 0 to 40 weeks) for cases and 16 weeks (range: 0 to 216 weeks) for controls. Lack of infant breastfeeding was associated with future diagnosis of pediatric-onset MS (odds ratio = 4.43; 95% confidence interval, 1.68 to 11.71; P = 0.003). This association remained significant after correcting for covariates, such as body mass index and age at diagnosis. ConclusionsThese data demonstrate that absence of infant breastfeeding has an association with an increased risk of pediatric-onset MS diagnosis.

Transition in Infant and Young Child Feeding Practices in India.

Optimal infant and young child feeding, which includes initiation of breastfeeding within one hour of birth, exclusive breastfeeding for first six months, age appropriate complementary feeding after six months along with continued breastfeeding for 2 years and beyond, is a public health intervention to prevent child morbidity, mortality and malnutrition [1]. In India, even though institutional delivery rates are increasing, only 44% women are able to breastfeed their babies within one hour of delivery. While 65% children are exclusively breast fed for the first six months, the median duration of breastfeeding is 24.4 months and complementary feeding rates are 50%. To achieve optimal IYCF practices, each woman should have access to a community based IYCF counseling support system. Efforts are therefore needed to upgrade skill based training of health workers and revive and update the Baby Friendly Hospital Initiative (BFHI). To promote and sustain breastfeeding amongst working women, it is essential to ensure adequate maternity leave, crèches at work place, flexible working hours, and provision of physical space for breast feeding at work place. It is imperative to also create public awareness about the dangers of bottle and formula feeding and to provide accurate information on the appropriate complementary food to be given to infants. In conclusion, India needs to make serious efforts to overcome malnutrition with not only prioritized IYCF policies but also their effective implementation in place.

Feeding Practices and Infant Growth: Quantifying the Effects of Breastfeeding Termination and Complementary Food Introduction on BMI z-Score Growth Velocity through Growth Curve Models.

Infant feeding practices are a focus of early obesity prevention. We tested whether infant growth velocity increased after breastfeeding termination and complementary food introduction. Our secondary analysis included a sample of 547 mother-infant dyads from a longitudinal randomized controlled trial conducted in Michigan and Colorado. Infant anthropometrics at birth, baseline, and 6- and 12-month follow-up were standardized to BMI-for-age z-score (ZBMI) according to World Health Organization (WHO) growth charts. We used growth curve models with time-varying predictors to quantify effects of breastfeeding termination and timing of complementary food introduction on growth velocity. Median breastfeeding duration was 2.0 months [confidence interval (CI) = 2.0-2.5]; median introduction of complementary foods occurred at 3.0 months (CI = 2.8-3.2). Breastfed infants not yet introduced to complementary foods had an average ZBMI growth velocity of 0.050 (CI = -0.013 to 0.113) z-score units per month [zpm], not significantly faster than WHO growth trajectory (p = 0.118) defined as 0 zpm. Breastfeeding termination had negligible effect on ZBMI growth velocity (γ11 = 0.001, CI = -0.027 to 0.030, p = 0.927). Introduction of complementary foods increased ZBMI growth velocity relative to an average child in the sample, but not significantly (γ12 = 0.033, CI = -0.034 to 0.100, p = 0.334). Growth velocities for infants receiving complementary foods both before and after breastfeeding termination were significantly faster than the WHO growth trajectory (0.083 zpm, CI = 0.052-0.114, and 0.084 zpm, CI = 0.064-0.105, respectively, p's < 0.001). Average postcomplementary food introduction growth velocity was significantly higher than WHO growth trajectory, but did not differ from the sample's initial average trajectory. Growth curve models can accurately estimate effects of feeding practices on infant growth to direct obesity prevention efforts.

Évaluation de l’effet du travail sur la pratique de l’allaitement maternel

Employment is recognized as a weaning factor in many studies. Our aim was to evaluate the impact of employment on women's breastfeeding (BF) with a duration longer than 6 months in a Moroccan population. A cross-sectional study was conducted between November 2015 and April 2016 in four hospitals in the region of Rabat-Salé, Morocco. All ages were included with the condition that the woman had at least one living child. A questionnaire-based interview collected data on the duration of BF for each child, breast milk storage practices, woman's opinion on BF, and the perception of work conditions during BF. Factors associated with BF lasting longer than 6 months were analyzed using logistic regression carried out in SPSS 13.0 software. A total of 502 surveyed women were analyzed. The median duration of breastfeeding (exclusive or mixed) in working women was 8 months versus 15 months for those without employment (P<0.001). Only 26% stored breast milk. For working women, BF practiced due to religious conviction or perceived as mandatory were higher than for unemployed women (18% vs 15% and 11% vs. 7%, respectively; P<0.001). Working conditions during BF were perceived as daunting in 61% of cases. In multivariate analysis, factors correlated with prolonged BF longer than 6 months were: (i) early baby initiation to BF (OR=3; 95% CI [1.9-4.6]), (ii) education level: middle and high school (OR=0.1; 95% CI [0.01-0.5]), and (iii) the social status of working women (OR=0.3; 95% CI [0.1-0.6]). Employment has a negative impact on the duration of breastfeeding, work perception, and practices of breastfeeding women.

Breastfeeding duration and associated factors between 1960 and 2000

ObjectiveTo describe a historical series on the median duration of breastfeeding in a population of mothers whose children were born from the 1960s onwards, identifying factors associated with the interruption of breastfeeding in each decade. MethodsData were analyzed from the Pró‐Saúde Study, a longitudinal epidemiological investigation started in 1999 among technical and administrative employees of a university in the state of Rio de Janeiro. Breastfeeding duration was collected in two study phases: phase 1 (1999), and phase 4 (2011‐2012). Of these, those who had at least one child and reported the duration of breastfeeding for the first child were selected (n=1539). To analyze the duration of breastfeeding, survival curves were constructed using the Kaplan‐Meier method and the effect of covariates on the duration of breastfeeding was estimated by Cox regression model. ResultsIt was found that the median duration of breastfeeding was higher in the 1990s and 2000s and lower in the 1970s, compared to the 1960s. In addition, there was an association between higher income and maternal age with breastfeeding interruption, which was focused in the 1970s. ConclusionThere was shorter duration of breastfeeding in the 1970s compared to the 1960s. Increased duration and prevalence of breastfeeding from the 1970s onwards coincided with the national trend and the promotion of this practice since 1980.