Optimal Breastfeeding Research Articles

Implementation of exclusive breastfeeding counseling for prospective brides in Lueng Bata District, Banda Aceh City

The importance of increasing knowledge about exclusive breastfeeding for expectant mothers in Aceh Province is an effort to achieve exclusive breastfeeding success above the national achievement of 69,7%. Optimal breastfeeding practices are one of the keys to success in reducing stunting. Counseling is essential in increasing the knowledge of prospective mothers or brides, supported by the use of media such as flyers that make it easier to understand the importance of exclusive breastfeeding for babies. This community service activity aims to increase the knowledge of prospective brides through counseling on exclusive breastfeeding using flyer media. Community service was carried out using a pretest-posttest non-equivalent group approach, namely providing exclusive breastfeeding counseling to prospective brides in Lueng Bata District. The number of participants was 20 people (10 couples), and activities were carried out in 2020. The counseling media is an exclusive breastfeeding flyer from the Indonesian Ministry of Health. Data collection was conducted through interviews using a questionnaire. The evaluation was carried out descriptively, consisting of a pretest and a posttest. The results showed an increase in average knowledge between before (26,3), and after (33,1) exclusive breastfeeding counseling was given using flyer media to prospective brides, or there was an increase in knowledge of 60,0%. In conclusion, through flyer media, exclusive breastfeeding counseling can improve the knowledge or understanding of prospective brides about exclusive breastfeeding.

Exclusive Breastfeeding and Childhood Morbidity: A Narrative Review.

Globally, diarrheal diseases and acute respiratory infections are the leading causes of morbidity and mortality in children under 5 years old. The benefits of exclusive breastfeeding in reducing the risk of gastrointestinal and respiratory infections are well documented. Optimal breastfeeding may potentially save the lives of about 800,000 children in low-income settings. Despite the evidence, around 63% of infants from birth to 6 months are not exclusively breastfed worldwide. We searched the literature published between 2010 and 2022 in Medline, Embase, and Scopus on the association between exclusive breastfeeding and infectious diseases. We selected and reviewed 70 relevant studies. Our findings expand and confirm the positive association between exclusive breastfeeding and reduced risk of a number of gastrointestinal, respiratory, and other infections in 60 out of 70 studies observed in both low- and high-income settings. Several studies analyzing exclusive breastfeeding duration reported that a longer exclusive breastfeeding duration is protective against many infectious diseases. This review also reported a lack of standardized definition for measuring exclusive breastfeeding in many studies. Overall, the results highlight the benefits of exclusive breastfeeding in many studies and suggests reporting exclusive breastfeeding in future studies using a consistent definition to enable better monitoring of exclusive breastfeeding rates.

Nursing Mothers' Experiences of Musculoskeletal Pain Attributed to Poor Posture During Breastfeeding: A Mixed Methods Study.

Background: Breastfeeding has various benefits for infants and mothers. However, if not performed in the correct posture, prolonged breastfeeding could cause musculoskeletal-related symptoms such as shoulder, neck, and upper back pain. In Jordan, nursing mothers do not have access to a breastfeeding midwifery team, a breastfeeding dietician, or a breastfeeding nurse for advice and education. The primary aim of this study was to explore nursing mothers' experiences of breastfeeding-related musculoskeletal pain; secondary aims were to explore nursing mothers' awareness of recommended breastfeeding postures and their experience of education and advice about breastfeeding postures. Methods: A cross-sectional mixed methods study was conducted with nursing mothers in Jordan who have breastfed their babies for 6 months or more following normal delivery, using an online survey questionnaire and semi-structured interviews. Participants were recruited through general practitioner clinics. Results: Four hundred ninety-three nursing mothers submitted the online questionnaire, and 12 interviews were completed. Nursing mothers reported experiencing nonspecific pain in lower back, neck, shoulder, and hand, attributed to breastfeeding. Pain in these joints affected mood, sleep, working ability, and quality of life by limiting activities of daily living. Findings showed that the majority of Jordanian nursing mothers did not receive education about safe or optimal breastfeeding positioning from health professionals. Conclusions: Nursing mothers in Jordan are not receiving appropriate education or advice about optimal postures for breastfeeding and have reported experiencing musculoskeletal pain, attributed to breastfeeding, that interferes with activities of daily living and affects quality of life. Postural education and advice should be provided to nursing mothers to prevent or avoid development of musculoskeletal pain.

Protecting both infant and mother: perceptions of infant feeding practices in rural Haiti

Background Global recommendations for optimal breastfeeding include early initiation, exclusivity for six months, and continued breastfeeding for two years and beyond. Although breastfeeding is near universal in Haiti, gaps in optimal practices persist. Determinants of breastfeeding practices are complex, and a contextualized understanding is needed to strengthen breastfeeding support interventions. We conducted a qualitative study to explore mothers’ perceptions of factors influencing breastfeeding practices in rural Haiti. Methods Focus group discussions were held in eight rural communes participating in a nutrition project. Study participants (n=86) were recruited from mothers’ support groups. A moderator facilitated the focus groups in Haitian Creole using a question guide to elicit observations about community breastfeeding practices related to early initiation, colostrum feeding, complementary foods and beverages, and breastfeeding cessation. Focus groups were recorded, and three observers took notes which were compiled into a single report of key points and validated by participants following each session. Quotes representing the key points were selected from the audio recordings, translated into English and analyzed to identify explanatory themes. Results Participants described breastfeeding for 12-18 months as the norm in study areas, with early and frequent use of additional foods and beverages. Three explanatory themes were identified, related to concerns for (i) infant well-being, including digestive health, nutritional needs and contentment; (ii) transmission of negative maternal emotional and physical states through breast milk; and (iii) maternal well-being, including effects on breastfeeding practices of maternal illness, hunger, stress, and competing time pressures. Underlying all these concerns is the context of rural poverty and the cultural meanings of breastfeeding. Conclusions Findings suggest that practices which compromise global breastfeeding recommendations may persist because of their perceived value in addressing concerns for infant and maternal well-being in the challenging context of rural poverty, food insecurity and poor health. Multi-sectoral interventions are needed to mitigate these underlying contributors and create an enabling environment for early, exclusive and continued breastfeeding.

Severe acute malnutrition and associated factors among children under-five years: A community based-cross sectional study in Ethiopia

BackgroundDespite consistent efforts to reduce child undernutrition, severe acute malnutrition (SAM) continues to be a serious obstacle to child survival and development in Ethiopia. This study aimed to identify severe acute malnutrition and associated factors among children aged 6–59 months in Ethiopia. MethodsA cross-sectional study was undertaken with 384 under-five children from February to March, 2020 in Ethiopia. A mid-upper arm circumference (MUAC) tape, weight scale, height board (standing) and recumbent length measurements (for children <24 months) were measured. To determine the variables associated with SAM, adjusted odds ratio was computed using multivariable analysis and p < 0.05 was declared as significant. ResultsThe prevalence of acute undernutrition was 26%; 18% and 8% of the children were moderately and severely undernourished, respectively. Family size (≥5 members) (AOR: 3.71, 95% CI: 1.55–8.89), younger age group (6–11 months) (AOR: 4.80, 95% CI: 1.61–14.31) and history of diarrhea in the two weeks prior to the survey (AOR: 5.36, 95% CI: 1.97–14.61) were independently associated with SAM in the study population. ConclusionLarge family size, child age, diarrheal and household insecurity were important determinants of SAM among children. Therefore, aligning social protection programmes and improving health related interventions along with improving optimal breastfeeding, prevention and control of child morbidity, and strengthening family planning services are recommended to reduce child SAM.

Design, Development, and Testing of BEST4Baby, an mHealth Technology to Support Exclusive Breastfeeding in India: Pilot Study.

BackgroundExclusive breastfeeding (EBF) at 6 months of age in most low- and middle-income countries, including India, is surprisingly low. There is a relative lack of mobile health apps that specifically focus on leveraging the use of peer counselors (PCs) to support mothers as a means of increasing EBF practices in low- and middle-income countries.ObjectiveThis study aimed to design, develop, and test the usability of Breastfeeding Education Support Tool for Baby (BEST4Baby), a mobile health app specifically designed to support PCs in providing in-home breastfeeding counseling support to mothers in rural India on optimal breastfeeding practices.MethodsA user-centered design process with an agile development methodology was used. The approach involved stakeholders and mothers who were trained to serve as PCs to guide BEST4Baby’s design and development, including the app’s content and features. PCs were engaged through focus groups with interactive wireframes. During the 24-month pilot study period, we conducted a feasibility test of the BEST4Baby app with 22 PCs who supported home visits with mothers residing in rural India. The intervention protocol required PCs to provide education and follow mothers using the BEST4Baby app, with 9 scheduled home visits from the late prenatal stage to 6 months post partum. BEST4Baby’s usability from the PCs’ perspective was assessed using the translated System Usability Scale (SUS).ResultsThe findings of this study align with best practices in user-centered design (ie, understanding user experience, including context with iterative design with stakeholders) to address EBF barriers. This led to the cultural tailoring and contextual alignment of an evidence-based World Health Organization breastfeeding program with an iterative design and agile development of the BEST4Baby app. A total of 22 PCs tested and rated the BEST4Baby app as highly usable, with a mean SUS score of 85.3 (SD 9.1), placing it over the 95th percentile for SUS scores. The approach translated into a highly usable BEST4Baby app for use by PCs in breastfeeding counseling, which also statistically increased EBF practices.ConclusionsThe findings suggest that BEST4Baby was highly usable and accepted by mothers serving as PCs to support other mothers in their EBF practices and led to positive outcomes in the intervention group’s EBF rates. The pilot study demonstrated that using the specially designed BEST4Baby app was an important support tool for mothers to serve as PCs during the 9 home visits.Trial RegistrationClinicaltrials.gov NCT03533725; https://clinicaltrials.gov/ct2/show/NCT03533725

Nasolabial and distal limbs dry gangrene in newborn due to hypernatremic dehydration with disseminated intravascular coagulation: a case report

IntroductionGangrene is the death of an organ or tissue due to lack of blood supply or bacterial infection. In neonates, gangrene is usually caused by sepsis, dehydration, maternal diabetes, asphyxia, or congenital anticoagulant deficiency. It commonly occurs in the extremities. Gangrene may lead to death or amputation of the limb. Early diagnosis and prompt management of the underlying cause halts the progression of the disease.Case presentationA 12-day-old neonate presented with a complaint of black discoloration of the nose and feet for 2 days. He was breastfeeding poorly and had signs of dehydration. Upon physical examination, he was tachycardic (pulse rate = 182 beats per minute), tachypneic (respiratory rate = 62 breaths per minute), and hypothermic (temperature = 35.0 oC). He lost 33.3% of his birth weight. He had demarcated cold, dry, and dark discoloration of the entire nose, nasal septum; upper lip; palate; bilateral distal lower limbs; and the left fifth finger. Dorsalis pedis arteries were not palpable on either side. On investigation, the baby had pancytopenia, hypernatremia, elevated creatinine, elevated coagulation profiles, and absent arterial flow in bilateral dorsal pedis arteries. He was treated for hypernatremic dehydration and possible sepsis. He was transfused with whole blood, platelets, and fresh frozen plasma, but finally, the patient passed away on the 7th day of admission.ConclusionThe entire nose, upper lip, soft and hard palate, symmetric lower limb, and fifth finger gangrene due to severe hypernatremic dehydration complicated by disseminated intravascular coagulation may occur in the same patient. To avoid such serious neonatal problems, mothers should be properly educated about optimal breastfeeding techniques and schedule well-child visits 3–5 days after birth.

Attitudes, Roles, and Community Perspectives Regarding Male Involvement in Breastfeeding in Juba, South Sudan

There is growing awareness that fathers’ infant-feeding preferences may influence mothers’ intentions to breastfeed and help promote optimal breastfeeding. Despite this understanding, fathers are not part of most breastfeeding promotion strategies such as ‘mother-to-mother’ support groups. This study examined male partners’ breastfeeding attitudes, roles, and community views on male involvement through quantitative and qualitative methods. We interviewed 275 fathers of children aged &lt;2 years, 15 key informants, and five focus groups to learn from the community. The data were analyzed using SPSS version 28.0; and thematically to generate frequency tables, median, interquartile range, and repeating patterns. Above 70% of fathers agreed that breastfeeding did not harm marriage or reduce women’s attractiveness. Breastfeeding in public is also accepted, and responsibilities are shared. The study also found support for &gt;80% of the critical roles, including housework, baby care, and holding and watching the mother breastfeed. Education level was significantly associated with breastfeeding attitudes (r=-0.207 p =0.001&lt;0.05) and roles (r=0.308, p=0.001&lt;0.05). Employment status was also significantly associated with attitudes (r=0.184, p=0.003&lt;0.05) and roles in breastfeeding (r=-0.155, p=0.007&lt;0.05). However, there was no significant association between hours of work and the attitudes/roles of male partners in breastfeeding (r=-0.074, p=0.125&gt;0.05 and r=0.049, p=0.224&gt;0.05, respectively). The key barriers that emerge included challenging patriarchy, gender role segregation; Sexism; false beliefs; and work-related, social, economic, and personal factors. The major cultural hurdles that emerged signify the need to develop context-specific strategies to dispel myths about male breastfeeding involvement and promote supporting practices.

What Are the Individual, Household, and Community Factors Associated With Optimal Breastfeeding Practices in Three Selected West African Countries?

Optimal breastfeeding is rarely practiced among mothers across the three studied countries: Guinea, Nigeria, and Sierra Leone. The methodological approach used in this study is the first of its kind in the study area. It provides answers to the statistical association between individual, household, and community factors and optimal breastfeeding practices. The study adopted a cross-sectional research design. It employed secondary data. The study data were extracted from the Demographic Health Surveys in Guinea (2012 GDHS), Nigeria (2013 NDHS), and Sierra Leone (2013 SLDHS). Information was extracted from mothers (20–49 years) who had at least one child before the surveys. Optimal breastfeeding was coded into “1” if adhered to and “0” if otherwise. Multilevel mixed-effect logistic regression was used. It was found that optimal breastfeeding was infrequently practiced in Guinea (5.3%), Nigeria (8.6%), and Sierra Leone (14.0%). The fixed-effects results showed that optimal breastfeeding was significantly associated with individual, household, and community-level factors (p &lt; .05). The random effect results showed that community factors accounted for 40.4%, 20.3%, and 20.7% variation in adherence to optimal breastfeeding for mothers in Guinea, Nigeria, and Sierra Leone, respectively. The study concluded that mothers in the study area rarely practice optimal breastfeeding.

Violations of the International Code (Code) of Marketing of Breast-milk Substitutes (BMS) in Health Systems of Burkina Faso and Cote d’Ivoire

ObjectivesMarketing of BMS continue to undermine breastfeeding globally. The health system is the most frequently used marketing platform in West Africa. In Burkina Faso (BF) and Cote d'Ivoire (CI), we aimed to understand the frequency and type of contacts between representatives of BMS companies and health workers, the presence of educational materials and branded equipment in health facilities, and their overall prevalence in public and private health facilities.MethodsIn 2021, we used the World Health Organization's NetCode protocol and conducted semi-structured interviews with health workers (130 in BF and 126 in CI) and mothers of children less than 2 years (330 in BF and in CI), and observations of educational materials in most urban facilities (43 in BF and 42 in CI). Contents of materials were analyzed to evaluate their compliance with the Code. Descriptive statistics and chi square tests were used to assess differences by child age and facility type (public vs. Private).ResultsHealth workers in BF (67%) and in CI (63%) were contacted by BMS companies with on-site visits being the most frequently used method. The main reasons given for contact were to provide samples for distribution and to provide incentives/gadgets for health workers and facilities. The overall knowledge of health workers on the Code was very low in both countries; only 8% in CI and 1% in BF had heard of it. 43% of mothers in Cote d'Ivoire and 24% in Burkina Faso were advised to feed their children BMS products in the last six months.ConclusionsStrong actions are needed in CI and BF to prevent BMS promotion in the health system, including increasing health workers’ knowledge of the International Code and national regulations, monitoring and sanctions imposed for violations, and reaching mothers and families with infant and young children to promote optimal breastfeeding practices.Funding SourcesBill & Melinda Gates Foundation through Alive & Thrive, managed by FHI Solutions.

Magnitude and determinants of breastfeeding initiation within one hour among reproductive women in Sub-Saharan Africa; evidence from demographic and health survey data: a multilevel study

BackgroundEarly initiation of breastfeeding is one of the most simple and essential intervention for child development and survival in the world. World Health Organization recommended to begin breast milk with one hour after delivery. The objective of this study was to determine the magnitude of early initiation of breastfeeding in Sub-Saharan Africa using DHS data set.MethodsThis study was carried out within 32 Sub-Saharan African countries from 2010–2020, a pooled study of early initiation of breastfeeding was performed. For assessing model fitness and contrast, intra-class correlation coefficient, median odds ratio, proportional change in variance, and deviance were used. In order to identify possible covariates associated with early initiation of breastfeeding in the study area, the multilevel multivariable logistic regression model was adapted. Adjusted Odds Ratio was used with 95% confidence interval to declare major breastfeeding factors.ResultThe pooled prevalence of early initiation of breastfeeding in Sub-Saharan Africa countries was 57% (95% CI; 56%—61%), the highest prevalence rate of early initiation of breastfeeding was found in Malawi while the lowest prevalence was found in Congo Brazzaville (24%). In multilevel multivariable logistic regression model; wealth index (AOR = 1.20; 95% CI 1.16 – 1.26), place of delivery (AOR = 1.97; 95% CI 1.89 – 2.05), skin-to-skin contact (AOR = 1.51; 95% CI 1.47 – 1.57), mode of delivery (AOR = 0.27; 95% CI 0.25 – 0.29), media exposure (AOR = 1.36; 95% CI 1.31 – 1.41) were significantly correlated with early initiation of breastfeeding in Sub-Saharan Africa.ConclusionThe magnitude of early initiation of breastfeeding rate was low in Sub-Saharan Africa. Covariates significantly associated with early initiation of breastfeeding was wealth index, place of delivery, mode of delivery, women educational status, and media exposure. Structural improvements are required for women with caesarean births to achieve optimal breastfeeding practice in Sub-Saharan Africa.

Breastfeeding Interpersonal Communication, Mobile Phone Support, and Mass Media Messaging Increase Exclusive Breastfeeding at 6 and 24 Weeks Among Clients of Private Health Facilities in Lagos, Nigeria

BackgroundAlthough most health facilities in urban Nigeria are privately owned, interventions to promote optimal breastfeeding practices in private facilities have not previously been implemented. ObjectivesWe tested the impact of a breastfeeding promotion intervention on early initiation of breastfeeding and exclusive breastfeeding among clients of private facilities in Lagos, Nigeria. MethodsThe intervention included training for health-care providers on the Baby-Friendly Hospital Initiative and breastfeeding counseling skills, provision of interpersonal communication and support to women at facilities and on WhatsApp, distribution of behavior change communication materials, and mobile phone and mass media messaging. We used logistic regression models adjusted for clustering to measure intervention impact in a cohort of women (n = 1200) at 10 intervention and 10 comparison facilities interviewed during their third trimester and at 6 and 24 weeks postpartum. ResultsThe intervention significantly increased the percentage of infants who were exclusively breastfed at 6 weeks (83% intervention; 76% comparison; P = 0.02) and 24 weeks (66% intervention; 52% comparison; P < 0.001), but had no impact on early initiation of breastfeeding (35% intervention; 33% comparison; P = 0.65). Among infants who were exclusively breastfed at 6 weeks, the odds of continued exclusive breastfeeding at 24 weeks were higher in the intervention arm than in the comparison arm (OR, 1.6; 95% CI: 1.2-2.1). Infants had increased odds of being exclusively breastfed at 6 weeks if their mothers discussed breastfeeding with a private health provider (OR, 2.3; 95% CI: 1.5-3.4), received text or WhatsApp messages about breastfeeding (OR, 1.7; 95% CI: 1.0-2.7), or heard breastfeeding radio spots (OR, 4.2; 95% CI: 1.2-14.7). Infants had increased odds of exclusive breastfeeding at 24 weeks if their mothers participated in a WhatsApp breastfeeding support group (OR, 1.5; 95% CI: 1.0-2.2). ConclusionsA breastfeeding intervention in private health facilities in Lagos increased exclusive breastfeeding. Implementation of breastfeeding interventions in private facilities could extend the reach of breastfeeding promotion programs in urban Nigeria. This trial was registered at clinicaltrials.gov as NCT04835051.

FACTORS AFFECTING ANXIETY OF BREAST MILK IN BREASTFEEDING MOTHERS : SCOPING REVIEW

Anxiety before and after childbirth can interfere with maternal function and mother-infant behavior including breastfeeding. Exclusive breastfeeding is breastfeeding alone without any additional food for 6 full months. Not all mothers give exclusive breastfeeding to their babies. This is influenced by various anxiety factors such as not initiating breastfeeding, breastfeeding duration. In this study using a scoping review methodology. This study combines knowledge and information related to current assumptions regarding the factors that influence exclusive breastfeeding. This study emphasizes breastfeeding anxiety factors such as breastfeeding initiation, breastfeeding duration and identifies 8 articles from a total of 8 articles, which were reviewed and summarized in a narrative manner. The findings of this study indicate that anxiety is the main factor for optimal breastfeeding. This research is expected to improve outcomes, and can be used as input for policy makers, health workers and service users.

Implementation of the Strategy for Breastfeeding and Complementary Feeding in the Federal District in Brazil.

Background: The Brazilian Breastfeeding and Complementary Feeding Strategy—Estratégia Amamenta e Alimenta Brasil (EAAB) aims to promote optimal breastfeeding (BF) and complementary feeding (CF) practices through the training of primary health professionals. Competition among health priorities and programs is one of the organizational contextual barriers to consolidating the implementation of the EAAB. Methods: This case study included six Primary Health Units (PHU) certified in the EAAB. Documentary analysis, interviews, and surveys were conducted, which informed a conceptual logical model. Organizational context indicators (positive and negative) were identified across the logical model based on the Matus Triangle, and they were used to analyze the degree of implementation of the EAAB in the PHUs. Results: The logic model elucidated six stages of EAAB implementation, but none on post-certification monitoring. Ten indicators positively influenced the implementation, including having legislation that prioritizes BF and CF. Seven indicators exerted negative influence, especially the lack of specific funding resources for the EAAB. Only one PHU had a consolidated degree of implementation. Conclusions: Lack of specific funding, monitoring of BF and CF practices, and compliance with certification criteria are the main challenges for the EAAB’s sustainability.

Bristol Breastfeeding Assessment Tool-Thai Version: Translation, Validity, and Reliability.

In 2019, 14.0% of infants in Thailand were exclusively breastfed up to 6 months of age. To increase exclusive breastfeeding, an objective assessment measure would be useful to maternity care providers for appraising the problems encountered by new mothers' experiences with breastfeeding. To translate the Bristol Breastfeeding Assessment Tool from English into Thai; to assess the reliability and validity of the Thai Bristol Breastfeeding Assessment Tool; and to explore the relationship of a mother's self-efficacy to successful breastfeeding. Using a methodological design, we purposively sampled 302 new mothers from two tertiary hospitals in Thailand who had given birth to a single baby with an uncomplicated vaginal birth. The Thai Bristol Breastfeeding Assessment Tool's structure was examined using confirmatory factor analysis. Concurrent and convergent validity were assessed using the Thai LATCH instrument and Thai Breastfeeding Self-Efficacy Scale, respectively. The inter-item Thai Bristol Breastfeeding Assessment Tool correlation coefficients were positive and strong. The correlation between scores of the Thai Bristol Breastfeeding Assessment Tool and Thai LATCH instrument were positive and strong and had acceptable concurrent validity. The confirmatory factor analysis model fit the Thai Bristol Breastfeeding Assessment Tool data perfectly and the Cronbach's alpha coefficient had acceptable internal reliability. The Thai Bristol Breastfeeding Assessment Tool is a cross-culturally translated instrument equivalent to its English version and demonstrated acceptable validity and reliability. The instrument provides a mechanism for an objective assessment and monitoring system of optimal breastfeeding practices in Thai mothers with newborns.

Faktor-faktor yang Mempengaruhi Pemberian ASI Esklusif di Wilayah Kerja Puskesmas Teluk Kijing Kecamatan Lais Tahun 2021

Exclusive breastfeeding without additional drinks or other foods. According to the 2030 Sustainable Development Goals or SDGs, optimal breastfeeding can save the lives of more than 820,000 children under 5 years old every year. However, only about 36% of infants aged 0-6 months worldwide were exclusively breastfed during the 2007-2014 period. The purpose of this study was to determine the factors of early initiation of breastfeeding (IMD), promotion of formula milk, and family support simultaneously with exclusive breastfeeding in the Teluk Kijing Public Health Center, Lais Subdistrict in 2021. The research design was a quantitative analytical survey with a cross sectional approach. The sample in this study were mothers who had babies 0-6 months in the Teluk Kijing Public Health Center working area, amounting to 70 respondents. The results of the univariate analysis of 70 respondents, most of the respondents gave exclusive breastfeeding, which amounted to 43 respondents (61.4%) and 27 respondents (38.6%) did not. The results of the bivariate analysis of the formula milk promotion variable with a p value (0.020), the IMD variable p value (0.038) and the family support variable with a p value (0.000) this shows that there is a relationship with exclusive breastfeeding in the Teluk Kijing Health Center Work Area, Lais District. 2021.

Adherence to Optimal Breastfeeding Practices Among HIV-Positive Mothers in Kilimanjaro, Tanzania.

PurposeWe sought to assess how HIV-positive mothers enrolled in the PMTCT program adhere to breastfeeding recommendations concerning early initiation of breastfeeding (EIBF), ie, within one hour of birth, pre-lacteal feeds, exclusive breastfeeding until six months (EBF), and continued breastfeeding to one year of age. This study was designed to assess the practices in response to changing recommendations for breastfeeding in HIV, which have differed drastically over the years.Patients and MethodsWe recruited 524 mother-child pairs from 37 PMTCT clinics across Kilimanjaro, Tanzania. The 5 clinics with the highest patient load in each of the 7 districts of Kilimanjaro were chosen, plus the zonal and municipal referral hospitals. The children were below two years of age and currently in the PMTCT program. We administered a questionnaire to assess the mother’s practices in feeding the child. We used multiple logistic regression models to determine factors associated with EIBF, EBF, and continued breastfeeding.ResultsEIBF was achieved for 73.1% of babies. Cesarean delivery, low birth weight, and partner disclosure of HIV status were significant risk factors for not achieving EIBF. About 19% of children did not breastfeed exclusively. Of the 247 children ≥12 months old, 43.3% had stopped breastfeeding before 12 months. Counseling on ARV, having had >2 pregnancies while HIV-positive and EBF were associated with breastfeeding until 12 months old. Using ART for more than two years decreased the odds of EBF and continued breastfeeding to 12 months of age.ConclusionAdherence to breastfeeding recommendations for HIV-positive women is suboptimal, particularly in aspects of recent changes in recommendations such as continuing breastfeeding for one year. There is a missed opportunity for interventions such as counseling, which has shown to favor adherence. Health education and counseling are needed for providers and mothers to keep them abreast with the frequently changing recommendations.

Determinants of Optimal Breastfeeding Practices in Indonesia: Findings From the 2017 Indonesia Demographic Health Survey.

ObjectivesUnderstanding the factors influencing mothers’ decision to breastfeed their infants is essential to formulate effective breastfeeding interventions. This study explored the determinants of optimal breastfeeding indicators in Indonesia.MethodsWe used the 2017 Indonesia Demographic and Health Survey to analyze factors associated with early initiation of breastfeeding, exclusive breastfeeding (EBF), and continued breastfeeding at 1 year (CBF-1) and 2 years (CBF-2). Multivariate logistic regression models were used to examine bio-demographic, socio-cultural, and behavioral characteristics associated with breastfeeding after considering the survey design effect.ResultsThe risk of delayed breastfeeding initiation was higher among infants who were born smaller, first-born children, were delivered via cesarean delivery, and did not have immediate skin-to-skin contact (p<0.01). Infant’s age, birth pattern, household wealth index, and the mother’s occupation and smoking status were predictors of EBF (p<0.05). CBF-1 was less common among first-time mothers and those working in the non-agricultural sector, mothers from wealthier families, and mothers who had cesarean deliveries (p<0.01). Infant’s age was negatively associated with CBF-2 (adjusted odds ratio [aOR], 0.85; 95% confidence interval [CI], 0.74 to 0.99). Mothers attending college were less likely to practice CBF-2 than those with no education or primary education (aOR, 0.45; 95% CI, 0.26 to 0.77). The absence of postnatal visits was a risk factor for CBF-1 and CBF-2 (p<0.05).ConclusionsBreastfeeding interventions in Indonesia should pay particular attention to at-risk groups such as women from wealthier families, working outside the agricultural sector, and with a higher education level. Nutrition-sensitive programs (e.g., postnatal care and smoking cessation) should also be encouraged.

Prevalence of stunting and its associated factors among children 6-59 months of age in pastoralist community, Northeast Ethiopia: A community-based cross-sectional study.

Globally, stunting is a significant public health concern and it is very critical in Ethiopia. This research aims to determine the prevalence of stunting and its correlates among children in the pastoral community. A community-based cross-sectional study was conducted in Dubti District, Afar Region, North East Ethiopia from 2-31 January 2018. A total of 554 children were recruited using a multi-stage sampling technique and participated in this study. A binary logistic regression analysis was performed to determine factors linked to stunting. The significance of the associations was determined at a p-value < 0.05 and the adjusted odds ratio at 95% CI was calculated to evaluate the strength of the associations. The prevalence of stunting was 39.5% (95% CI: 35.4-43.5%). The odds of stunting were increased, so does the age of the child increased as compared to 6-11 months of children. Initiating breastfeeding after 1 hour after birth (AOR = 1.99; 95% CI: 1.22, 3.23), not exclusively breastfeeding for at least 6 months (AOR = 2.57; 95% CI: 1.49, 4.42), poor dietary diversity (AOR = 1.93; 95% CI: 1.03, 3.62), and using unprotected water for drinking (AOR = 1.68; 95% CI: 1.21, 2.94) were significant factors. Among children aged 6-59 months, the level of stunting in the pastoral community was significantly high. The study found that stunting was associated with multiple nutritional and non-nutritional factors. To tackle stunting, inter-sectoral cooperation is needed by enhancing the clean water supply of the community, optimal breastfeeding practice, food diversity, and economic status.

Factors Associated With Pre-Lacteal Feeding Practices Among Mothers Having Children Aged 0-36 Months in Bangladesh: Evidence From Bangladesh Demographic and Health Survey 2017-18.

Despite being a known barrier to optimal breast-feeding indicators, the practice of Pre-lacteal Feeding (PLF) remains a key challenge in Bangladesh. This study examines the prevalence and underlying factors associated with PLF, for which data from a weighted sample of 4982 Bangladeshi mothers with children aged 0 to 36 months from the 2017-18 Bangladesh Demographic and Health Survey was used. Step-by-step multivariate logistic regression was performed to identify the association of significant determinants of PLF practices. Nearly 29% newborns received PLF before breastmilk and timely initiation of breastfeeding did not happen in case of 20.5% babies. The odds of PLF were significantly higher among the inhabitants of Dhaka division compared to other regions. In addition, birth-related factors such as optimal ANC visits (P < .01), home delivery (P < .01) and delivered by cesarean section (P < .01) showed significantly higher odds of introducing PLF to the newborns. Our results demonstrated the need for developing targeted policies and actions to prevent such practices of PLF in order to improve optimal breastfeeding behavior in Bangladesh.