Period Of Exclusive Breastfeeding Research Articles

Undernutrition among exclusive breastfeeding mothers and its associated factors in Southwest Ethiopia: A community-based study.

An exclusive breastfeeding period is a time when the infant's feeding depends on only breast milk. Inadequate maternal nutrition during this period could lead to insufficient infant feeding, which can further lead to childhood undernutrition and developmental restrictions. Evidently, the burden of maternal undernutrition was higher in resource-limited countries, including Ethiopia. This study aimed to assess the proportion of undernutrition among exclusive breastfeeding mothers and its associated factors in Southwest Ethiopia. The study used a community-based cross-sectional design. The study was conducted among 442 nursing mothers from 10 to 30 June 2022. The participants were selected using multistage sampling techniques. An interviewer-administered structured questionnaire was used to collect information. Statistical software EpiData version 3.1 and SPSS version 20 were used for data entry and analysis, respectively. The factors associated with undernutrition were identified using a binary logistic regression analysis. In the bivariable analysis, a p-value of less than 0.25 was used to include the variable in the multivariable analysis, whereas p-value less than 0.05 was an odds ratio used to declare an independent association at a 95% confidence interval. The proportion of undernutrition among the participants was found to be 24.8% in the study area. Poor intake of extra meals (adjusted odds ratio = 2.104; 95% confidence interval: 1.208, 3.664), poor dietary diversity habits (adjusted odds ratio = 3.605; 95% confidence interval: 2.112, 6.153), a lack of nutrition information (adjusted odds ratio = 1.853; 95% confidence interval: 1.070, 3.212), and household food insecurity (adjusted odds ratio = 4.424; 95% confidence interval: 2.639, 7.417) were identified as factors enhancing undernutrition among exclusive breastfeeding mothers in the area. A quarter of exclusive breastfeeding mothers were undernourished in the area. Poor dietary diversity habits, poor intake of extra meals, a lack of nutrition information, and household food insecurity were found to be the factors determining undernutrition. Hence, it is important to reinforce nutrition intervention programs, including maternal nutrition education and counseling.

“Because of mchango, I give my baby gripe water so he sleeps and stops crying”: Exclusive breastfeeding and parents’ concerns about colic-like symptoms in infants under 6 months in Lake Zone, Tanzania

BackgroundEffective social and behavior change strategies for exclusive breastfeeding (EBF) rely on understanding how families interpret infant behavior and provide care. Little research thoroughly explores household use of non-prescribed medicine for infants under 6 months in rural Tanzania, which can interrupt EBF and may have other harmful unintended effects.
 AimTo explore parents’ use of non-prescribed medicine in response to infants’ colic-like symptoms during the EBF period.
 MethodsWe conducted thematic analysis of a series of qualitative, semi-structured interviews with 36 mothers and 30 fathers of infants 0-6 months in Lake Zone, Tanzania. Here, we focus on emergent themes related to concerns about colic-like symptoms and global implications for public health practitioners.
 ResultsParents reported concerns about excessive crying and perceived infant abdominal pain, attributed to a potentially serious disease state locally known as mchango. Most parents gave non-prescribed medicines (e.g. gripe water, oral traditional medicine, and/or other commercial medicines) to treat or prevent mchango and associated symptoms, often including infant crying. After receiving supportive counselling on soothing techniques, most were willing to avoid giving non-prescribed medicines. Some reported continued challenges attributed to mchango symptoms, namely inconsolable crying.
 ConclusionWhile symptoms of mchango reported in this study overlapped with colic symptoms, literature in Tanzania suggests, in some cases, mchango is perceived to have spiritual origins and potentially be dangerous if left untreated. Empathetic counseling can offer parents knowledge and skills to manage colic-like symptoms without using non-prescribed medicines. Health workers need clear messages and training on risks of non-prescribed medicines and Tanzanian legislation banning its promotion and distribution.

Breastfeeding after return to work: An Australian national workplace survey.

Breastfeeding initiation rates in Australia are high but duration rates fall well below the World Health Organization targets. Return to work is a known factor impacting 6 months exclusive breastfeeding and continuation into the infants second year of life. Work related factors can influence a woman's confidence in maintaining breastmilk supply after return to employment and determine whether she meets her personal breastfeeding goals. This cross-sectional online survey is the first Australian study to explore women's experience of maintaining breastfeeding after return to work, in all work sectors. Results revealed variations across work sectors reflected in worker autonomy and confidence in speaking up about breastfeeding rights. Women who had autonomy or flexibility in planning their workday were more likely to be confident in maintaining breastmilk supply. The main predictors for milk supply confidence and meeting personal breastfeeding goals included having: a suitable place to express milk; confidence in speaking out about rights; a formal return-to-work plan; a supportive workplace; and returning to work after the period of exclusive breastfeeding. This study reveals that supportive workplace environments can lead to increased confidence in maintaining milk supply, extending durations of breastfeeding. Women who are confident in their rights to express breastmilk, or breastfeed at work, are more likely to meet their own breastfeeding goals. Education, and awareness raising, on the rights of breastfeeding women in the workplace, is a gender equity imperative that can improve experiences for breastfeeding women, and, increase manager and co-worker knowledge for creating enabling workplace environments for breastfeeding employees.

Improvement the practices of complementary feeding through local wisdom-based complementary feeding education videos

The incidence of stunting is a major nutritional problem faced by Indonesia. The most decisive intervention to reduce the prevalence of stunting includes the provision of complementary foods to infants. Empowerment of mothers during the complementary feeding period can give positive results on the nutritional status of children. The purpose of the study was to identify the effect of MPASI education videos based on local wisdom on maternal practices and nutritional status of infants 6-24 months. The research design was a quasi-experimental with a two group pre-post test design, sample of 40 mothers of infants 6-24 months which taken by consecutive sampling. The results showed that there were differences in mother's practice before and after the complementary feeding education video (p value < 0.001; = 0.05), while there was no difference in nutritional status before and after the video was given. This study recommends providing MPASI educational media for mothers during the exclusive breastfeeding period as a preventive measure for early complementary feeding and increasing maternal readiness before the complementary feeding period.

Quantitative glycoproteomics of human milk and association with atopic disease.

The prevalence of allergic diseases and asthma is increasing rapidly worldwide, with environmental and lifestyle behaviors implicated as a reason. Epidemiological studies have shown that children who grow up on farms are at lower risk of developing childhood atopic disease, indicating the presence of a protective "farm effect". The Old Order Mennonite (OOM) community in Upstate New York have traditional, agrarian lifestyles, a low rate of atopic disease, and long periods of exclusive breastfeeding. Human milk proteins are heavily glycosylated, although there is a paucity of studies investigating the milk glycoproteome. In this study, we have used quantitative glycoproteomics to compare the N-glycoprotein profiles of 54 milk samples from Rochester urban/suburban and OOM mothers, two populations with different lifestyles, exposures, and risk of atopic disease. We also compared N-glycoprotein profiles according to the presence or absence of atopic disease in the mothers and, separately, the children. We identified 79 N-glycopeptides from 15 different proteins and found that proteins including immunoglobulin A1, polymeric immunoglobulin receptor, and lactotransferrin displayed significant glycan heterogeneity. We found that the abundances of 38 glycopeptides differed significantly between Rochester and OOM mothers and also identified four glycopeptides with significantly different abundances between all comparisons. These four glycopeptides may be associated with the development of atopic disease. The findings of this study suggest that the differential glycosylation of milk proteins could be linked to atopic disease.

Exclusively Breastfed Infant Microbiota Develops over Time and Is Associated with Human Milk Oligosaccharide Intakes.

Temporal development of maternal and infant microbiomes during early life impacts short- and long-term infant health. This study aimed to characterize bacterial dynamics within maternal faecal, human milk (HM), infant oral, and infant faecal samples during the exclusive breastfeeding period and to document associations between human milk oligosaccharide (HMO) intakes and infant oral and faecal bacterial profiles. Maternal and infant samples (n = 10) were collected at 2–5, 30, 60, 90 and 120 days postpartum and the full-length 16S ribosomal RNA (rRNA) gene was sequenced. Nineteen HMOs were quantitated using high-performance liquid chromatography. Bacterial profiles were unique to each sample type and changed significantly over time, with a large degree of intra- and inter-individual variation in all sample types. Beta diversity was stable over time within infant faecal, maternal faecal and HM samples, however, the infant oral microbiota at day 2–5 significantly differed from all other time points (all p < 0.02). HMO concentrations and intakes significantly differed over time, and HMO intakes showed differential associations with taxa observed in infant oral and faecal samples. The direct clinical relevance of this, however, is unknown. Regardless, future studies should account for intakes of HMOs when modelling the impact of HM on infant growth, as it may have implications for infant microbiota development.

THE EFFECT OF GRANDMOTHER’S SUPPORT UPON BREASTFEEDING PROCESS, IN TURKEY

AIMS: This study was carried out to define the support of the grandmother during the breastfeeding process. METHODS: This study with descriptive quality was carried out between January and July 2020 with 305 mothers of six-month and younger babies. The data were collected from four Family Health Centers with high population density in Erzincan city center. The data were collected with a questionnaire form created by the researcher. Percentage, mean, independent groups t-test, analysis of variance and Pearson correlation analysis were used to analyze the data. RESULTS: It was found that the mean age for the babies of the mothers was 3.57±1.97 and the mean time of exclusive breastfeeding (EBF) was 2.95±2.24. During the breastfeeding process, it was determined that 76.1% of the mothers got support from the grandmothers during the postpartum period, 66.9% got support for breastfeeding, baby care, housework and hosting visitors during the postpartum period, 28.5% were subjected to recommendations such as breastfeeding more often, expressing their milk, resting more, eating lactogenic food to have more breast milk and staying away from stress, 36.1% did not receive any comments on breastfeeding, 56.4% got nutritional advice rather than breast milk, 32.6% was recommended on water, sherbet and 73.8% had recommended complementary food. It was found that the grandmother’s support during the puerperium and their advice and comments during the breastfeeding process were efficient variables upon the EBF period up to the present (p&lt;0.05). It was also determined that there was a positive correlation between the duration of EBF given by mothers and duration of the grandmother’s stay during the puerperium (p&lt;0.05). CONCLUSIONS: It was determined that majority of the mothers had support from grandmothers during the breastfeeding process, took advice, did not comment, and these had a positive effect upon the EBF period up to the present. However, it was found that grandmothers gave nutritional advice rather than breast milk and majority of mothers gave the recommended nutrition.

Assessment and Factors Influencing Protein Content of Human Breast Milk at Various Stages of Lactation in Yobe State Nigeria

Aims: Aim: Protein in breast milk has diverse functions which gives short and long term benefits. This means human milk must adequately supply the nutritional needs of infants especially during the period of exclusive breast feeding as mandated for lactating mothers. The study assessed quantity of proteins in lactating stages of mother’s breast milk and the factors that influence its availability in Yobe State, Nigeria.&#x0D; Study Design: Quantitative experimental and descriptive survey methods were adopted for the study. Quantitative experimental design was used for the analysis of breast milk samples collected while descriptive survey method was used to derive primary and secondary data to determine factors influencing protein in breast milk.&#x0D; Place and Duration of Study: The collection of the samples was done in three stages of lactation from October to December (2019) in Yobe State, Nigeria.&#x0D; Methodology: Primiparous women residing in Nguru (n= 49/town) were recruited base on agreement with the hospitals prior to their delivery. Breast milk samples were collected at three stages of lactation; colostrums (1-2 days), transition (12 day) and mature (30 day) for protein analysis. Descriptive survey through structured questionnaire was adopted to derive primary data which was used to determine nutrition during pregnancy and factors influencing breast milk composition.&#x0D; Results: The mean proteins are 3.88%, 1.79% and 1.23% for colostrum, transition and mature milk respectively. It showed that breast milk is a dynamic fluid with changes in its protein content over the course of lactation and varies within and between nutrition and between mothers. Those with low, normal and high BMI accounted for 6.1%, 81.6% and 12.2% respectively. Based on WHO standard, 82% of the women has normal BMI during pregnancy which translate good nutrition.&#x0D; Conclusion: The nutrition of the pregnant women influenced breast milk proteins. Age, ethnicity, religion and parity have no significant effect on protein quantity in breast milk. Increased education stratification and income levels contribute positively to proteins in lactation stages.

Comparison of the key modifiable factors in the first 1000 days predicting subsequent overweight and obesity in pre-school children in Tehran: a case-control study.

The identification of paediatric obesity predictors in the early stages of life is warranted, as it can influence the development of effective strategies to prevent metabolic disorders. In this case-control study, we assessed nine risk factors for paediatric obesity, namely a birth weight > 4000 g, an exclusive breast-feeding period < 4 months, the introduction of solid food at < 4 months, maternal overweight or obesity before pregnancy, maternal smoking during pregnancy, the presence of gestational diabetes, paternal overweight and obesity and paternal smoking. In order to identify the most relevant predictors of paediatric obesity, we employed a multiple logistic regression model with R2 Cox Snell by adjusting confounders. In the randomly selected 509 preschool children from Tehran, children exposed to gestational diabetes had the maximum predicted probability of obesity (4·36 (1·94, 9·80) %) among the analysed risk factors %. The introduction of solid food at < 4 months of age increased the risk of obesity by 2·98 (1·77, 4·97 %). The OR of childhood obesity was associated with maternal overweight and obesity (2·72(1·60-4·60) %), maternal smoking (2·21 (1·18, 4·11) %) and excessive gestational weight gain (1·89 (1·23, 2·91) %). Paternal smoking and high birth weight increased the risk of paediatrics obesity > 1·8 times (1·15-2·94) and > 1·5 times (1·015-2·43), respectively. There was no association between the paternal BMI, the exclusive breast-feeding time and the risk of paediatric obesity. Among early risk factors, probably gestational diabetes can be considered as the most important predictor for the risk of paediatric obesity.

Barriers to exclusive breastfeeding: A cross-sectional study among mothers in Ho Chi Minh City, Vietnam.

Exclusive breastfeeding provides numerous benefits to the health of infants, mothers, economics, and the environment. However, during the exclusive breastfeeding period, the mothers face many barriers. This study aimed to describe the perceived barrier of breastfeeding and compare its differences among mothers in Vietnam according to demographic and individual characteristics. A cross-sectional study was conducted among 246 women in Ho Chi Minh City, Vietnam. Data were derived from the original survey using a self-administered questionnaire asking about the barriers of breastfeeding in three aspects: maternal, infant, and socio-environment. Descriptive statistics, Independent t-test, and ANOVA were used to describe the mothers' characteristics and the breastfeeding barriers. The barrier from the infants was the most noticeable, followed by socio-environment and maternal barriers, respectively. Breastfeeding in public places (M = 2.93, SD = 0.92), baby's illness (M = 2.74, SD = 0.99), and insufficient milk supply (M = 2.70, SD =0.99) were considered as major barriers to six-month exclusive breastfeeding among mothers in Ho Chi Minh City, Vietnam. Among the age groups, mothers who were more than 35 years old perceived had lower breastfeeding barriers than the younger mothers (F = 3.67, p = 0.03). The investigation of the barriers against exclusive breastfeeding practice can help nurses and midwives develop breastfeeding promotion programs to promote exclusive breastfeeding rate for women in Vietnam.

Perceptions of grandmothers and HIV-infected mothers on infant feeding practices in a rural South African district

BackgroundDespite enormous interventions aimed at preventing mother-to-child transmission (MTCT) of HIV, cultural practices on mixed infant feeding remain prevalent. Complementary food provision to infants seems to be the most common and acceptable form of infant feeding highly endorsed by grandmothers.AimThis study aimed to explore the perceptions of grandmothers and HIV-infected mothers on infant feeding practices in the context of prevention of mother-to-child transmission.SettingThis study was undertaken in two primary healthcare facilities in the Mpumalanga province, South Africa.MethodsA qualitative exploratory narrative design was used to conduct four focus group discussions with 32 purposefully selected grandmothers and 21 in-depth interviews with postnatal HIV-infected women in the two identified health facilities. Data were analysed using an interthematic inductive analysis approach, resulting in major themes and subthemes supported by participants’ excerpts.ResultsFour themes emerged showing (1) high mixed feeding endorsement because of the need to adhere to conventional practices, strengthen the umbilicus and have fuller, fat and calmer babies; (2) infant feeding fallacies and stigma reflected by exclusive breastfeeding period confusion, breastfeeding scepticism and infant feeding stigma; (3) breastfeeding endorsement for other disease prevention and family support for breastfeeding and (4) conflict between traditional and western infant feeding approaches.ConclusionTotal elimination of MTCT of HIV in a rural context calls for targeted education for grandmothers addressing their perceptions and practices of infant feeding. The knowledge of the identified factors encouraging mixed infant feeding can assist in designing programmes to change community beliefs on infant feeding. Cultural, social and psychosocial factors should be addressed when making recommendations for exclusive breastfeeding for HIV-positive mothers.

ASSESSMENT OF KNOWLEDGE REGARDING BREASTFEEDING AMONG PREGNANT WOMEN/MOTHERS VISITING TERTIARY CARE HOSPITAL IN PUNJAB PROVINCE OF PAKISTAN

Background: Breastfeeding is essential for an individual's fundamental health starting from birth till the later stages of life. There is sound evidence for the positive impact of breastfeeding on the health of children, mothers and the community as a whole. A heavy percentage of infants are still devoid of optimal breastfeeding in Pakistan. One of the major factors contributing to this is reduced knowledge about benefits and practice of breastfeeding among mothers. The present research was carried out to assess the knowledge of women regarding breastfeeding. Methods: This was a cross-sectional study carried out in Sir Ganga Ram Hospital in the capital city of Punjab from the 1st to 7th of August 2017 during the world breastfeeding week as part of breastfeeding awareness campaign.200 women attending the obstetrical and pediatric outpatient departments were randomly selected. Following informed consent, a self-designed 5-item questionnaire was handed over to pregnant women and mothers and the completed questionnaires were collected by the investigator. The data was entered and analyzed using SPSS version 22. Results: 200 pregnant women completely filled the questionnaire. Only 12.5% knew that breast milk should be the first intake of the babies while 33% knew that it should be initiated in the first hour of birth. 23% knew that exclusive breastfeeding should be continued for up to 6 months. 44% said that babies should be breastfed for up to 10 to 20 times day and only 29% knew that only breast milk should be given to the babies during the period of exclusive breastfeeding. The total knowledge score calculated was 17.14+-2.34 and was found to be positively related to age of the mother, her educational status and the number of children. Conclusion: There is good knowledge about breastfeeding amongst pregnant women and mothers visiting the outpatient department of Sir Ganga Ram Hospital, Lahore. There is a need of creating awareness amongst them through workshops, seminars and awareness campaigns.

How does women's bone health recover after lactation? A systematic review and meta-analysis.

This is a systematic review aiming to evaluate the recovery of bone mass after lactation-related loss. Bone loss is transitory with recovery depending on the return of menstruation and weaning, and several compensatory homeostatic mechanisms are involved to minimize any significant damage to the maternal skeleton. Lactation has been associated with significant temporary bone loss, especially during the exclusive breastfeeding period. In the bone recovery phase, there is wide methodological heterogeneity among clinical trials, including follow-up timing, methods and sites of bone measurements, and body composition changes. The purpose of this study is to perform a systematic review and meta-analysis aiming to evaluate the recovery rate of bone mass after lactation-related loss, including the PubMed, Web of Science, and Scopus databases, with no publication date restrictions. The following MeSH terms were used: "bone diseases," "bone resorption," "bone density," "osteoporosis," "calcium," "postpartum period," "weaning," "breast feeding," and "lactation." The inclusion criteria were as follows: prospective human studies in women of reproductive age and bone measurements with two assessments in the postpartum period at least: the first one within the first weeks of lactation and another one 12 months after delivery, 3 months following the return of menses or 3 months postweaning. This research was recorded on the Prospero database (CRD42018096586Bone). A total of 9455 studies were found and 32 papers met the inclusion criteria. The follow-up period ranged from one to 3.6 years postpartum. Lactation was associated with transient bone loss, with a strong tendency to recover in all the sites studied, depending on the return of menstruation and weaning. Small deficits in the microarchitecture of the peripheral skeleton may be present, especially in women with prolonged breastfeeding, but with no deficit regarding the hip geometry was found. Women with a successive gestation after prolonged lactation and women who had breastfed when adolescents had no significant bone loss. Bone loss related to lactation is transitory, and several compensatory homeostatic mechanisms are involved to minimize any significant damage to the maternal skeleton.

APOIO SOCIAL E INTERCORRÊNCIAS MAMÁRIAS EM NUTRIZES QUE AMAMENTAM EXCLUSIVAMENTE

Objetivo: Avaliar a associação entre o apoio do cônjuge e de familiares a nutrizes assistidas em um Programa de Puericultura de um Banco de Leite Humano e as intercorrências mamárias durante o período de aleitamento materno exclusivo (AME). Métodos: Estudo transversal com 169 nutrizes assistidas pelo Programa de Puericultura de um Banco de Leite Humano em São Luís-MA. Aplicou-se um questionário semiestruturado para a coleta de dados socioeconômicos e demográficos, condições do pré-natal, apoio social e intercorrências mamárias. O Teste Qui-quadrado e o Teste Exato de Fischer foram empregados para verificar as associações entre as covariáveis e o desfecho de interesse (p&lt;0.05). Resultados: Todas as nutrizes se submeteram ao pré-natal (100%), das quais 81,3% realizaram seis ou mais consultas, em sua maioria na rede pública de saúde (94,7%). Mais da metade das nutrizes não recebeu orientações a respeito do aleitamento materno (55,4%), de posições do bebê para amamentar (63,7%) e dos cuidados com as mamas durante o pré-natal (59,2%). Aproximadamente 82% receberam apoio do companheiro, no entanto, na presença de dores nos mamilos (41,1%) e mamilos ausentes, planos ou invertidos (13,2%), a maioria (86,8%) não recebeu tal suporte durante o AME (p=0,021). Conclusão: Houve considerável apoio social dirigido às nutrizes, mas dentre as que apresentaram intercorrências mamárias, a maior parte não recebeu esse apoio. Reforça-se a necessidade de maior participação dos atores que compõem a rede social da gestante no pré-natal e nos cuidados com a saúde da criança.DOI: 10.12957/demetra.2019.43824

The effect of breastfeeding training on exclusive breastfeeding: a randomized controlled trial

Introduction Although exclusive breastfeeding is very beneficial for children’s and mothers’ health, a limited number of infants are exclusively breastfed for 6 months. Aim This randomized controlled intervention study aims to determine the effect of breastfeeding training on mothers’ knowledge, behaviors, and exclusive breastfeeding for 6 months. Materials and methods The participants were selected randomly for training (n = 60) and control groups (n = 60) among the pregnant women admitted to the obstetrics and gynecology polyclinics of a baby-friendly hospital. The training group received breastfeeding training during the prenatal and postnatal periods. The data were collected using a questionnaire during admission and at the postpartum 1st and 24th weeks through face-to-face interviews. The study was completed with 34 and 30 mother–infant pairs in the training and control groups, respectively. Analyzed using the chi-square, Student t, Mann–Whitney U, and Wilcoxon t-tests. Results The difference between the number of correct answers in pre- and posttest was higher in the training group (four questions) than in the control group (two questions) (p < .001). The number of mothers exclusively breastfeeding for 6 months was significantly higher in the training group (26.5%) than in the control group (3.3%) (p = .015). The median of the exclusive breastfeeding period was longer in the training group (5 months) than in the control group (4 months) (p = .013). Conclusion Training and supporting pregnant women and breastfeeding mothers on breastfeeding increased their knowledge, the period of exclusive breastfeeding, and the rate of 6-month exclusive breastfeeding.

The role of intention and self-efficacy on the association between breastfeeding of first and second child, a Danish cohort study

BackgroundThe impact of parity on breastfeeding duration may be explained by physiological as well as psychosocial factors. The aim in the present study was to investigate the mediating influence of intention and self-efficacy on the association between the breastfeeding duration of the first and the following child.MethodsA 5-year Danish cohort study with data from online questionnaires was used. Data came from 1162 women, who participated in the “Ready for child” trial in 2006–7 and gave birth to their second child within 5 years in 2011–3. Analysis included multiple regression models with exclusive/any breastfeeding duration of first child as the exposure variables, intention and self-efficacy measured as mediators, and exclusive/any breastfeeding duration of the second child as the outcome variables.ResultsDuration of exclusive breastfeeding of the first child was significantly associated with exclusive breastfeeding duration of the second child (p < 0.001) and with the self-reported intention and self-efficacy in the ability to breastfeed the second child (p < 0.001). The exclusive breastfeeding period was slightly longer for the second child. Self-efficacy and intention mediated the association between breastfeeding duration in the first and second child. Together the two factors explained 48% of the association in exclusive breastfeeding and 27% of the association in any breastfeeding between the first and second child.ConclusionDue to a reinforcing effect of intention and self-efficacy, breastfeeding support should focus on helping the first time mothers to succeed as well as to identify the second time mother with low self-efficacy and additional need for support.

Association Between Breastfeeding and Childhood Breathing Patterns: A Systematic Review and Meta-Analysis.

This systematic review aimed to evaluate the association between breastfeeding and breathing patterns in children. We searched PubMed, EMBASE, Web of Science, CINAHL, and the Cochrane Central Register of Controlled Trials for publications from inception to October 1, 2017. The breastfeeding duration and period of exclusive breastfeeding were selected as primary outcomes. The odds ratio (OR) and 95% confidence interval (CI) were calculated. A meta-analysis was conducted to synthesize the evidence. The Newcastle-Ottawa Score was used for quality and comparability assessment. Of the 54 articles identified, three observational studies met the inclusion criteria for this meta-analysis, representing 1,046 participants. The results of the meta-analysis revealed that the prevalence rate of mouth breathing (OR = 2.04; 95% CI, 1.26-3.31; p = 0.004) was significantly higher in subjects who were breastfed for less than 6 months, but no significant difference was observed within the periods of exclusive breastfeeding (6 months or less) (OR = 1.27; 95% CI, 0.73-2.21; p = 0.40). We found only limited evidence about the association between breastfeeding and breathing patterns. However, the current evidence supports the association between breastfeeding and childhood breathing patterns. Based on this review, we found that the frequency of normal nasal respiration increases with the duration of breastfeeding. The methodological quality of the studies included was moderate. Thus, future studies should aim to correct the confounding factors related to breathing patterns, to use standardized diagnostic criteria of mouth breathing, and to conduct a prospective research to reduce the recall bias.

Breastfeeding practices among mothers of infants in Peringara Panchayat in Pathanamthitta District

The study was aimed to assess the breastfeeding practices among mothers of infants in Peringara Gramapanchayat in Kerala. Study was a community based cross-sectional study among mothers of infants in Peringara gramapanchayat using a pretested questionnaire. 142 breastfeeding mothers of infants in Peringara gramapanchayat were studied and mothers who were not present at home during the study were excluded from the study. Study period consisted of 18 days between December 2015 and January 2016. Study variables includes type of delivery, initiation of breastfeeding, breastfeeding practices and role of ASHAs in promoting good breastfeeding practices. Statistical analysis was done using Pearson’s Chi-square test and T test. The study found that exclusive breastfeeding has been done by 68.3% of mothers. There is no practice of giving pre-lacteal feed, 95.8% of mothers have given colostrum to the new born. Statistically significant association was found between the type of delivery and time of initiation of breastfeeding (p less than 0.05). Time of initiation of breastfeeding was prolonged in case of Caesarean section. 49.3% of mothers have breastfed the baby within one hour. 55.6% of mothers were informed about importance of breastfeeding by ASHAs and only 20.4% of mothers were informed about period of exclusive breastfeeding and period of complimentary feeding by ASHAs.

Mother chair reparation to decrease subjective disorders in exclusive breast-feeding period

Exclusive breastfeeding is the responsibility of the mother after childbirth. A specific constraint arise for the mother when during the breastfeeding process, the place is not in accordance with the physiological condition of the mother's body. A not physiologically corrected lactation place will cause subjective disorders for breastfeeding mothers. Complaints that arise include quick tiredness, with certain muscles sore and pain, which will ultimately decrease the motivation of the mothers to perform exclusive breastfeeding especially in the first six months of the baby's birth. An improved ergonomic designed chair, this research used experimental method with group within treatment (treatment by subject) to solve the problem. The study took place in Maternity Clinic “CB” Badung regency, Bali. Subjective disorders are measured based on general fatigue and musculoskeletal disorders mothers breastfeeding. Fatigue is predicted using 30 items of questionnaires while musculoskeletal compaints are predicted from the Nordic Body Map questionnaire. Data were analyzed descriptively and inferentially in an experiment condition using using t-pair test. The results showed that there were significant differences in fatigue in general and skeletal musculoskeletal disorders between treatment 1 (using old chair) with treatment 2 (using repaired seats) in breastfeeding mothers. Fatigue in general decreased by 35.6% and skeletal musculoskeletal disorders decreased by 26.8%. It was concluded that improved breastfeeding mothers' seats may decrease subjective disorders during exclusive breastfeeding. It is therefore advisable for breastfeeding mothers to use seats that match their anthropometry.

Determinants of nutritional status in children under three years of age in rural Zimbabwe: the case of Shamva and Makoni Districts

Background: Malnutrition contributes significantly to the child health burden in developing countries. Stunting, wasting and underweight are associated with poor physical growth, increased morbidity, mortality and retarded cognitive development.Objective: The main objective of this study was to assess determinants of malnutrition among children under three years of age from rural households.Setting and Design: A cross-sectional study carried out in Shamva and Makoni districts of ZimbabweSubjects: A total of 186 mother-child pairs were randomly selected and an interviewer-administered questionnaire was used to capture socio-demographic data from participants. Scales, wooden height-boards and Mid-Upper Arm Circumference tapes were used to take anthropometric measurements using the WHO guidelines. The Statistical Package for Social Sciences (SPSS) and Emergency Nutrition Assessment for Standardised Monitoring and Assessment of Relief and Transition (ENA for SMART) software packages were used to analyse data. The World Health Organization (2006) reference standards were used to calculate z-scores.Results: Child wasting, underweight and stunting prevalences were 8.6%, 7% and 18% respectively. Overweight was 11.6% among children. Mother's Body Mass Index (p=0.044), marital status (p=0.035), household income (p=0.021), low birth weight (p=0.029) and duration of exclusive breastfeeding (p=0.014) were found to be significant determinants of malnutrition. The prevalence of stunting and underweight was higher among boys compared to girls (p=0.038 and p=0.040) while the risk increased with age (p=0.041).Conclusions: Mother's Body Mass Index (BMI), marital status and household income were determinants of malnutrition. The main individual determinants of malnutrition among under-three children were low birth weight and reduced period of exclusive breastfeeding.