Exclusive Breastfeeding Rates Research Articles

Identifying and understanding barriers to optimal complementary feeding in Kenya.

Optimal complementary feeding between the ages of 6 and 23 months provides children with the required range of nutritious and safe foods while continuing to be breastfed to meet their needs for essential nutrients and develop their full physical and cognitive potential. The rates of exclusive breastfeeding in the first 6 months of life have increased from 32% in 2008to 60% in 2022 in Kenya. However, the proportion of children between 6 and 23 months receiving a minimum acceptable diet remains low and has declined from 39% in 2008to 31% in 2023. The Kenyan Ministry of Health, GAINand UNICEF collaborated to understand the drivers of complementary feeding practices, particularly proximal determinants, which can be directly addressed and acted upon. A secondary analysis of household surveys and food composition data was conducted to outline children's dietary patterns within the different regions of Kenya and the extent to which the affordability of animal-source foods could be improved. Ethnographic data were analyzed to identify socio-cultural barriers to optimal complementary feeding. Furthermore, we outlined the critical steps for developing user-friendly and low-cost complementary feeding recipes. The results of all the analyses are presented in five of the six papers of this Special Issue with this additional paper introducing the Kenyan context and some of the critical findings. The Special Issue has highlighted multidimensional barriers surrounding the use and availability of animal-source foods. Furthermore, it emphasizes the need for a multi-sectoral approach in enacting policies and programmes that address these barriers.

Association Between Exclusive Breastfeeding and Acute Respiratory Infections Among Infants Under the Age of 6 Months.

Introduction: Acute respiratory infection (ARI) is the leading cause of childhood morbidity and mortality. Exclusive breastfeeding is considered the cornerstone of child health; however, the rate of exclusive breastfeeding is suboptimal in low- and middle-income countries (LMICs). This study aimed to assess the association between exclusive breastfeeding and ARI among infants under the age of 6 months in a LMIC. Methods: A secondary analysis of the 2014 Egypt Demographic Health Survey data was conducted. Mothers of infants under the age of 6 months (n = 1,340) were included. The outcome of interest was ARI symptoms among infants, defined by mother's report of a cough accompanied by fast or difficult breathing in the 2 weeks preceding the survey. The exposure variable was exclusive breastfeeding, defined by giving infants only breast milk during the first 6 months of life. Descriptive statistics and multivariate regression were performed. Results: Forty-one percent of the infants were exclusively breastfed and 9% had ARI symptoms. Exclusive breastfeeding reduced the odds of ARI symptoms (adjusted odds ratio [AOR] = 0.450, 95% confidence interval [CI]: 0.243-0.832). Infants of mothers 20-34 years of age (AOR = 0.421, 95% CI: 0.217-0.817) and ≥35 years (AOR = 0.308, 95% CI: 0.123-0.767) at childbirth were less likely to have symptoms of an ARI when compared with adolescent mothers. The likelihood of having ARI symptoms was higher among infants 2-3 months of age (AOR = 2.437, 95% CI: 1.093-5.435), and 4-5 months (AOR = 2.888, 95% CI: 1.193-6.992) compared with infants less than 2 months. Conclusion: Exclusive breastfeeding was protective against ARI symptoms among under-6-month infants, independent of potential confounders.

Поддержка грудного вскармливания в акушерских стационарах

Aim. To evaluate the implementation of the modern breastfeeding support principles into the practice of the maternity hospitals in Moscow. Design. Observational cohort study. Materials and methods. The study was conducted on the basis of two maternity hospitals in Moscow. With the help of a questionnaire specially developed by us, an anonymous survey of maternity patients was conducted at the time of discharge. A total of 614 mothers were interviewed from October 2020 to July 2021. Results. In general, the clinical practice of breastfeeding support in the maternity hospitals has demonstrated its stability and compliance with the criteria recommended by WHO for monitoring the main clinical practices. The rate of exclusive breastfeeding at the time of discharge from the hospital was 83.9%. The majority of mothers were satisfied with the breastfeeding support provided to them (90.9%). Mothers highly appreciated the work of lactation consultants introduced into the staffing of hospitals. Nevertheless, shortcomings were also identified in the implemented practice of breastfeeding support that requires improvement. Conclusion. The introduction of modern practice of breastfeeding support in maternity hospitals contributes to an increase in the level of breastfeeding among maternity hospitals, including exclusively breastfeeding from birth. To achieve the sustainability of this practice, it is necessary administration support, training of the medical staff, including lactation consultants, and monitoring of the breastfeeding practice. Keywords: breastfeeding, maternity hospitals, “Ten steps of breastfeeding support”.

Breastfeeding at discharge and in the third stage of the Kangaroo Mother Care among hospitalized preterm infants.

To identify the type of feeding and analyze the sociodemographic and clinical factors associated with exclusive breastfeeding at hospital discharge, in the first and in the last follow-up visit of the third stage of the Kangaroo Mother Care among infants admitted to the kangaroo unit. Longitudinal and retrospective study. A total of 186 infants of gestational age <37 weeks admitted to the kangaroo unit in 2018 and 2019 was included. Data collected from medical records and subjected to inferential analysis and the Poisson regression model (P < 0.05). Exclusive breastfeeding rate was 73.1% at discharge, with a drop at the last follow-up visit (68.1%). At discharge, there was a greater probability of exclusive breastfeeding in younger mothers, with higher education, infants born with higher birth weight and who received exclusive human milk during hospitalization; in the first follow-up visit, in a younger mother and infant who received only human milk during hospitalization; and in the last follow-up visit, a young mother, infant who received only human milk and suckled at the breast for the first time in the kangaroo unit. Most infants hospitalized in the second stage of the Kangaroo Mother Care were exclusively breastfed and presented maternal and clinical factors related to breastfeeding. This fact can help manage the challenges of the method and promote breastfeeding.

Improving health indicators of mothers and newborns by empowering communities in urban slums of Mumbai, Maharashtra, India

Abstract Background: Newborns represent the most vulnerable segment of our society, constituting nearly 30% of all under-5 mortality cases. Despite well-established healthcare systems in metropolitan areas, urban slum dwellers, comprising approximately 50%–60% of the population, often lack access to these services. The Society for Nutrition, Education, and Health Action (SNEHA) operates within urban slums, aiming to enhance health outcomes for mothers and children. At SNEHA, we firmly believe that a healthy society starts with the well-being of mothers and infants. Our organization is dedicated to empowering communities to improve the health status of newborns in urban slums. Material and Methods: As part of the intervention, 7819 households with a population of 35,000 were targeted. SNEHA’s field workers conducted regular visits to these households, providing counseling on breastfeeding immunization and identifying potential health risks. Married women of reproductive age were specifically identified and consistently educated about the significance of early pregnancy registration. Pregnant women received support for registering their pregnancies, attending regular antenatal care (ANC) check-ups, adhering to ANC visit schedules, and maintaining adequate iron, calcium, and nutrition intake. Additionally, they were informed about the advantages of institutional delivery and encouraged to prepare for childbirth. Mothers of children under 2 years were urged to bring them to primary health centers for routine immunizations. Furthermore, they were advised on contraception methods to ensure proper spacing between children. Results: Our endeavors have resulted in a 34% rise in early pregnancy registration, a 22% increase in the number of women attending four antenatal check-ups, an 11% uptick in institutional deliveries, a 24% improvement in exclusive breastfeeding rates, and a notable 67% surge in the prevalence of contraception. Conclusion: Our intervention has proven that it is possible to improve the health indicators of women and children through behavior change communication, regular home visits, and community awareness.

Promoting maternal-child health by increasing breastfeeding rates: a National Canadian Baby-Friendly Initiative Quality Improvement Collaborative Project

While breastfeeding has long been an important, globally recognized aspect of population health, disparities exist across Canada. The Baby-Friendly Initiative (BFI) is a WHO/UNICEF best-practice program that helps ensure families...

Third stage of the kangaroo method: exclusive breastfeeding and growth of preterm and/or low birth weight newborns.

To evaluate the rates of exclusive breastfeeding (EBF) and growth of preterm and/or low birth weight newborns during the third stage of the Kangaroo Method (TSKM), at discharge. Retrospective study in a reference public maternity hospital between Jan/2014 and Dec/2017, including the preterm (less than 37 weeks) and/or low birth weight (less than 2500 g) newborn infants. Information was collected from medical records. Statistics analysis was done in SPSS software. 482 infants were included and followed up at the TSKM ambulatory. The average gestational age was 33 weeks (variation: 24-39 weeks) and birth weight, 1715g (variation: 455-2830 g). EBF occurred in 336 (70.1%) infants at hospital discharge, and in 291 (60.4%) at TSKM discharge. Each additional day of hospital stay increased the chance of infant formula (IF) use by 9.3% at hospital discharge and by 10.3% at TSKM discharge. Staying in the Kangaroo Neonatal Intermediate Care Unit (KNICU) favored EBF at hospital discharge and TSKM discharge (p<0.001). Not performing the kangaroo position increased the chance formula administration to the newborn infant at hospital discharge by 11%. Weight gain and head circumference growth were higher in infants using formula (p<0.001). The length of hospital stay and not performing the kangaroo position favored the use of infant formula at hospital and TSKM discharge. Staying in the KNICU favored exclusive breastfeeding at hospital and TSKM discharge. Weight gain and HC growth were higher in newborns receiving infant formula.

Prevalence of Exclusive Breastfeeding among Nursing Mothers in Afijio Local Government Area, Southwest, Nigeria: A Cross-sectional Study

Background: Exclusive breastfeeding is public health intervention strategy for child health development and growth from birth to weaning period. It is recommended for nursing mothers during Health promotion sessions by Health Educators according to WHO AND UNICEF guidelines at various health facilities. Nigeria recorded 17.5% prevalence rate of exclusive breastfeeding despite regional variations. This is relatively low to WHO recommendations. Hitherto no study has been conducted in Afijio Local Government, South west of Nigeria for prevalence of exclusive breastfeeding. Hence the aim of this study is to evaluate Knowledge, Altitude and Practice of exclusive breastfeeding by distribution of questionnaires to nursing mothers in Afijio Local Government areas. Methodology: a cross sectional study of randomly selected 172 nursing mothers from Ilora, Awe, Jobele/ Akinmoorin and Fiditi of Afijio Local Government Area. Data analysis was employed by frequency, relative frequency and simple percentage. Results: A total number of 172 nursing mothers were interviewed with mean age of 33 ± 4.0 years. The literacy level is 97%. The employment rate is 65%. Formal education received on knowledge of exclusive breast feeding by respondents (Prevalence) is 89.0 %. The altitude of the participants on benefits of exclusive breastfeeding is 78.5%. Finally, practice of breastfeeding especially within first hours of birth is 84%. Conclusion: There is need for more support from local government’s health authority on exclusive breast feeding in Afijio Local Government Areas. Thus training courses should be provided to skilled birth attendants for skilled support to breastfeeding mothers.

Comparing the effectiveness of a breastfeeding arm sling with the normal cross-cradle hold position: A quasi-experimental study in Thailand.

In Thailand, the exclusive breastfeeding rate remains low at 14% in 2019, despite the World Health Organization's recommendation of exclusive breastfeeding for the first six months. Many mothers experience challenges such as lack of confidence, fatigue, and discomfort while breastfeeding. To address these issues, the novel arm sling innovation device was developed to provide support during breastfeeding. This study aimed to compare the effectiveness of breastfeeding using the arm sling versus the normal cross-cradle hold among first-time mothers and to evaluate their satisfaction with the breastfeeding arm sling. A quasi-experimental crossover design was employed in the postpartum unit at Ramathibodi Hospital, Thailand, in 2022. Forty-six first-time mothers breastfed using both a breastfeeding arm sling and the normal cross-cradle hold, with a washout period in between. Breastfeeding effectiveness was measured by mothers and nurse-midwives using questionnaires, and mothers' satisfaction with the sling was assessed. Data were evaluated using descriptive statistics and t-tests. The breastfeeding arm sling innovation significantly improved breastfeeding effectiveness compared to the normal cross-cradle hold, reported by both mothers (t=4.32, p<0.001) and nurse-midwives (t=8.93, p<0.001). Most mothers expressed satisfaction with the arm sling, though some design aspects, such as ease of use, require improvement. This study suggests that the breastfeeding arm sling can potentially improve breastfeeding experiences for first-time mothers. Further research is needed on a larger scale and in more diverse settings to confirm these findings and to improve the sling's design for user-friendliness.

Trends in epidemiological characteristics and etiologies of diarrheal disease in children under five: an ecological study based on Global Burden of Disease study 2021

BackgroundDiarrhea remains a significant health threat to children under five years of age. The study aims to systematically elucidate the global burden of diarrhea in children, providing scientific insights for effective prevention and control strategies. MethodsThe data from the Global Burden of Disease (GBD) 2021 study was analyzed to assess the trends in incidence, prevalence, mortality, and disability-adjusted life years (DALYs) of diarrhea in children under five years across the globe, 21 geographical region, and 204 countries and territories, stratified by age group, sex, and socio-demographic index (SDI) levels. The trend of the disease burden for childhood diarrhea from 1990 to 2021 was described and estimated using the average annual percent change (AAPC), and a Bayesian age-period-cohort (BAPC) model was employed to predict the future burden of diarrhea in children. ResultsFrom 1990 to 2021, there was a significant decline in the global burden of diarrhea among children under five years of age. The AAPC for incidence (−4092.18, 95% confidence interval [CI]: −4224.60 to −3959.76), prevalence (−70.98, 95% CI: −72.67 to −69.28), mortality (−6.89, 95% CI: −6.95 to −6.83), and DALYs rate (−621.79, 95% CI: −627.20 to −616.38) of diarrhea in children all showed a marked downward trend. Diarrheal incidence (r = −0.782, P < 0.001), prevalence (r = −0.777, P < 0.001), mortality (r = −0.908, P < 0.001), and DALYs rate (r = −0.904, P < 0.001) were negatively correlated with the SDI. Between 2022 and 2035, the global incidence, prevalence, and mortality rates of diarrhea in children under five years are projected to continue declining. The leading causes of diarrheal mortality in children include wasting, underweight, and non-exclusive breastfeeding. Rotavirus remains the predominant pathogen associated with diarrhea-related mortality rate and DALY rate. ConclusionAlthough the global burden of diarrhea in children under five has steadily declined, it remains a significant health threat. Rotavirus is the leading pathogen, highlighting the importance of expanding rotavirus vaccination. Additionally, improving nutritional status, increasing exclusive breastfeeding rates, and enhancing access to sanitation and clean drinking water are crucial measures that, when widely implemented, can effectively reduce the health risks posed by diarrhea in children.

SOCIO-CULTURAL DETERMINANTS OF EXCLUSIVE BREASTFEEDING AND INFANT FEEDING PRACTICES IN NIGER

Background&#x0D; Niger has one of the lowest exclusive breastfeeding (EBF) rates in the world. Prelacteal feeding practices may contribute to low EBF rates, but research on the barriers related to EBF in Niger is limited.&#x0D; Objective&#x0D; The purpose of this study was to identify socio-cultural determinants for, and barriers to, EBF during an infant’s first 6 months through maternal perspectives in Niamey, the capital of Niger.&#x0D; Methods&#x0D; Participants were mothers with children aged 0 to 24 months in Niamey, Niger. Participants completed an interview including a 20-item questionnaire on socio-demographics, breastfeeding support and knowledge, a short food security survey, and a 24-hour diet recall. Infant anthropometric data (height, weight, upper arm circumference) was collected from patient records.&#x0D; Results&#x0D; All participants (n=31) breastfed and a majority of the mothers were planning to breastfeed until the child reached 18 months old. No mother among the participants practiced EBF for the recommended 6 months because of the common practice of prelacteal feeding, where solid or liquid foods were introduced before 6 months of age. Most participants stated that they were instructed on how to feed their child by a close relative such as their mother or sister, while health professionals rarely gave such instructions.&#x0D; Conclusions&#x0D; Exclusive breastfeeding is not a common practice among mothers in Niamey. Even though many breastfeed their infant for a relatively long duration, the participants disclosed that they often feed their infants solid and liquid foods before they reach the recommended age for complementary feeding, and sometimes within 48 hours after birth. Study results may inform the development of breastfeeding education components in clinics where mothers attend pre and postnatal consultations.

Učestalost dojenja u ordinacijama primarne pedijatrijske zaštite u Republici Hrvatskoj tijekom trogodišnjeg razdoblja (2020.-2022.)

The goal of the research is to present data on the prevalence of breastfeeding in the Republic of Croatia for a three-year peroid. In cooperation with the Ministry of Health, the Croatian Institute of Public Health and the Department of Business Analysis of the MCS Group, data on the nutrition of children in the Republic of Croatia for years 2020, 2021 and 2022, have been extracted from the MCS Group database. In total, 63,969 records on the type of nutrition of infants and 15,871 records on the type of nutrition of children older than one year were processed, and collected from 55,042 children in total. The percentage of children exclusively breastfed for 1 month is 56.49%, for 3 months 46.09%, and for 6 months 9.66%. When it comes to complementary feeding, 47.87% of children were breastfed for 9 months, 37.26% for 12 months, and 7.64% for 24 months. The first month of a child’s life is characterized by a sudden drop in the number of breastfed children, compared to the percentage of breastfeeding represented in maternity hospitals. The rate of exclusive breastfeeding for six months is significantly below the rate recommended by WHO and UNICEF. The differences in the recommendations of WHO and UNICEF, the European Association for Pediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN), and the European Academy of Allergology and Clinical Immunology (EACCI) can be confusing for some health workers and parents. The results of total breastfeeding in months 12 and 24 are slightly below the values reported as the current rates of breastfeeding in the world by UNICEF. According to the current state of breastfeeding in the Republic of Croatia, the breastfeeding goals for 2030, set by WHO and UNICEF, will be difficult to achieve without reorganization and strengthening of the role of pediatricians in primary health care.

The lactation and chestfeeding/breastfeeding information, care and support needs of trans and non-binary parents: An integrative literature review

Background: The National Breastfeeding Strategy launched by the Ministry of Health in 2020, commits to the protection, promotion and support for breastfeeding with the aim of increasing exclusive breastfeeding rates in Aotearoa New Zealand. This strategy includes a recommendation that the breastfeeding/chestfeeding information and support needs of trans and non-binary parents and their whānau are identified so that those involved in their care are knowledgeable about these specific needs. Midwives are the primary providers of lactation and breastfeeding/chestfeeding information, care and support for most pregnant people in Aotearoa New Zealand. Aims: An integrative literature review was undertaken: to ascertain the specific lactation and chestfeeding/breastfeeding information and care needs for trans, non-binary, takatāpui and other gender diverse whānau; to consider the implications of this knowledge for contemporary midwifery in Aotearoa New Zealand; and to identify continuing research needs. Method: Literature for this integrative review was primarily sourced through the Ovid Online Database using search terms pertinent to the topic and limited to articles published in peer reviewed journals in English, excluding editorials, commentaries and opinion pieces. Findings: Literature about trans and non-binary parents and chestfeeding/breastfeeding, although increasing since 2010, is limited internationally and absent nationally. From extant literature, connections between healthcare barriers and the negative experiences of trans and non-binary parents are identified and explored in three overarching themes: the foundations of Western perinatal healthcare systems; the invisibility of trans and non-binary people within perinatal healthcare systems; and the lack of perinatal healthcare provider knowledge. Conclusion: Cis-normative, gender binary foundations are omnipresent in perinatal healthcare, rendering trans and non-binary people invisible, and excluded from this space. These factors contribute to the limiting of perinatal healthcare provider knowledge, an overwhelming finding in the literature. The absence of locally produced literature presents scope for research production here in Aotearoa New Zealand, exploring this topic from our unique cultural contexts. Such contributions may help inform whether adaptations and additions to current midwifery education are necessary to support midwives in the provision of equitable, safe, culturally appropriate, gender-inclusive care.

Rate of Exclusive Breastfeeding Among Postpartum Mothers at Hoima Regional Referral Hospital's Postnatal Clinic

Despite active promotion, Uganda reports that 36% of children under 6 months are not exclusively breastfed, impacting infant health. This study focuses on 428 interviews within the Kampala district's informal sector, aiming to understand exclusive breastfeeding practices among mothers with infants aged 0–5 months. Results indicated a 41.1% prevalence of exclusive breastfeeding. Factors linked to this practice included attending antenatal care at least four times, intending to breastfeed exclusively for six months or more, adopting proper breastfeeding techniques, and the age of the infant. Notably, working in lower positions was associated with a lower likelihood of exclusive breastfeeding. Recommendations emphasize the importance of antenatal care in educating mothers about exclusive breastfeeding's advantages, enabling informed decisions. Additionally, enforcing maternity leave benefits outlined in Uganda's Employment Act within the informal sector can support women in practicing exclusive breastfeeding. Keywords: Exclusive breastfeeding, Children below 6 months, Antenatal care, Maternity leave

Examining the Benefits of Water Births in a Hospital Setting: Perspectives from Midwives and Nurses

Objective: This study aimed to investigate the impact of midwifery-led care on maternal outcomes, maternal satisfaction, and newborn health in a hospital setting. Specifically, the study sought to compare the effects of midwifery-led care to standard care models, assess maternal preparedness for childbirth, explore rates of medical interventions, evaluate maternal satisfaction, and examine newborn health outcomes. Methods: A total of 200 expectant mothers receiving prenatal care at a tertiary hospital were recruited and randomly assigned to two groups: Group A (midwifery-led care) and Group B (standard care). Participants' demographic information, medical history, and preferences related to prenatal care were collected using a structured questionnaire. Validated surveys, including the Edinburgh Postnatal Depression Scale (EPDS), were used to assess postpartum depression. Medical records and prenatal visits were reviewed throughout the pregnancy, and postpartum follow-ups were scheduled to assess maternal outcomes. Statistical analyses were performed to compare outcomes between the two groups. Results: Participants in the midwifery-led care group reported significantly higher levels of birth preparedness (p &lt; 0.001), and rates of medical interventions during childbirth, including cesarean sections, were significantly lower compared to the standard care group (p &lt; 0.05). Maternal satisfaction scores were significantly higher in the midwifery-led care group (p &lt; 0.001). Additionally, the midwifery-led care group showed lower rates of postpartum depression (p &lt; 0.01) and higher rates of exclusive breastfeeding at six weeks postpartum (p &lt; 0.05). Neonates born to mothers in the midwifery-led care group had significantly lower rates of neonatal complications (p &lt; 0.01). Conclusion: The findings of this study provide strong evidence for the positive impact of midwifery-led care on maternal outcomes, maternal satisfaction, and newborn health. The personalized and woman-centered approach of midwifery-led care contributes to improved maternal preparedness, reduced medical interventions, increased maternal satisfaction, lower rates of postpartum depression, and better newborn health outcomes. These results highlight the potential benefits of integrating midwifery-led care models into maternity services, aiming to enhance the overall birthing experience and improve maternal and infant health outcomes.

Precocious infant fecal microbiome promotes enterocyte barrier dysfuction, altered neuroendocrine signaling and associates with increased childhood obesity risk

ABSTRACT Early life gut microbiome composition has been correlated with childhood obesity, though microbial functional contributions to disease origins remain unclear. Here, using an infant birth cohort (n = 349) we identify a distinct fecal microbiota composition in 1-month-old infants with the lowest rate of exclusive breastfeeding, that relates with higher relative risk for obesity and overweight phenotypes at two years. Higher-risk infant fecal microbiomes exhibited accelerated taxonomic and functional maturation and broad-ranging metabolic reprogramming, including reduced concentrations of neuro-endocrine signals. In vitro, exposure of enterocytes to fecal extracts from higher-risk infants led to upregulation of genes associated with obesity and with expansion of nutrient sensing enteroendocrine progenitor cells. Fecal extracts from higher-risk infants also promoted enterocyte barrier dysfunction. These data implicate dysregulation of infant microbiome functional development, and more specifically promotion of enteroendocrine signaling and epithelial barrier impairment in the early-life developmental origins of childhood obesity.

Deskripsi Dukungan Keluarga dan Pengetahuan Ibu terhadap Praktik Pemberian ASI Eksklusif

Background: Exclusive breastfeeding is giving only breast milk to babies aged 0-6 months without giving additional liquids such as formula milk, orange juice, honey, tea, water without additional solid foods such as bananas, papaya, porridge, milk, biscuits and Nasi Tim, but not many mothers are willing to give exclusive breastfeeding for 6 months as suggested by the world health organization (Haryono and Setianigsih, 2018). In 2018 the coverage of exclusive breastfeeding in Indonesia was 29.5% with the lowest coverage (Ministry of Health RI, 2018). Research objectives: To find out the description of family support, mother's knowledge, and exclusive breastfeeding in Sintung Village, Pringgarata District, Central Lombok Regency. Research method: The research used is analytic research with a cross-sectional approach, namely research by measuring, observing at the same time between the dependent variable and the independent variable (one time). Results: Based on the results of the study, it was concluded that there is a positive relationship between the level of knowledge of mothers and the decision to exclusively breastfeed toddlers, in other words, the lack of exclusive breastfeeding rates in Sintung Village, one of which is due to the lack of knowledge of mothers about the importance of exclusive breastfeeding for toddlers. And there is also a positive relationship between family support and the decision to exclusively breastfeed toddlers, in other words, the lack of exclusive breastfeeding in Sintung Village, one of which is due to the lack of family support for mothers who have toddlers. Research results: Based on the research conducted, it was found that out of 64 respondents, only 31 respondents (48.4%) said that toddlers in their families were exclusively breastfed. On the other hand, 33 respondents (51.6%) said that infants in their families were not exclusively breastfed. Based on the samples surveyed, it can be said that the rate of exclusive breastfeeding in Sintung Village is still not high enough. Differences in the level of knowledge of mothers significantly affect the decision of exclusive breastfeeding for toddlers, where the better the level of knowledge of mothers, there is a high tendency to provide exclusive breastfeeding for toddlers. Likewise, differences in family support significantly affect the decision to provide exclusive breastfeeding for toddlers, where with family support, there is a high tendency to provide exclusive breastfeeding for toddlers.

Determinants of Exclusive Breastfeeding Rate in Central Region of Ghana Health

The prevalence of exclusive breastfeeding (EBF) has recently garnered significant attention from public health experts. Recognised as a cost-effective strategy, EBF significantly enhances the well-being of both mothers and infants. This study investigates the factors influencing exclusive breastfeeding (EBF) practices in Ghana's Central Region, with a focus on the role of socio-demographic characteristics. The study used a cross-sectional study design and a structured questionnaire to collect data from 358 breastfeeding mothers across 15 health centres in the Central Region of Ghana. The findings reveal a weak but statistically significant correlation between socio-demographic characteristics and EBF practices (Pearson correlation r = 0.179, P = 0.001), indicating that factors such as maternal age, education, marital status, and number of births modestly influence EBF practices. Similarly, a weak negative correlation was observed between socio-demographic factors and current breastfeeding rates (Pearson correlation = 0.105 r = 0.105, P = 0.048), suggesting some level of impact by these variables. However, the relationship between working status and breastfeeding practices was found to be non-significant (Pearson correlation = 0.011, r = 0.011, P = 0.181). Based on these findings, the study recommends tailored public health interventions that address specific demographic characteristics, enhanced awareness and education on EBF, the development of breastfeeding-friendly workplace policies, and further research utilising qualitative methods to better understand the complexities of breastfeeding behavior.

The Analysis Relationship of Exclusive Breastfeeding with Psychosocial Problems in Children Aged 4-6 Years

Psychosocial health is one of the most important factors in achieving optimal growth and development in children. The increase in psychosocial problems among children has been accompanied by a decrease in the rate of exclusive breastfeeding over the past two years. Another important aspect is the history of natural disasters such as tsunamis, military operations, and the implementation of Islamic law in Aceh. This research aims to explore the relationship between exclusive breastfeeding and psychosocial problems in children in the city of Banda Aceh.The research method employed in this study is an analytical observational design with a cross-sectional approach. The population of this research comprises all children aged 4-6 years old. Samples were obtained using a cluster sampling technique, involving 296 children from 5 villages around one of the public health centers in Banda Aceh. Data analysis in this study is conducted using a logistic regression test.The results of the study indicate that the percentage of children aged 4-6 years in Banda Aceh who have received exclusive breastfeeding is 261 children (88.18%), while the number of children with psychosocial problems based on the Pediatric Symptom Checklist 17 is 27 children (9.12%). There is a significant relationship between exclusive breastfeeding and psychosocial problems in children aged 4-6 years in the working area of the Baiturrahman Public Health Center in Banda Aceh. Children who did not receive exclusive breastfeeding have a 5 times higher risk of experiencing psychosocial disorders compared to children who received exclusive breastfeeding during the first 6 months of life

Effectiveness of a breastfeeding promotion intervention model based on Society ecosystems Theory for maternal women: a study protocol of randomized controlled trial

BackgroundBreastfeeding is recognized internationally as the most scientific and effective way to feed infants and young children. According to the World Health Organization in 2022, the exclusive breastfeeding rate within 6 months is 34.1% in China, which is still far from the goal of “more than 60% exclusive breastfeeding rate of infants within 6 months” by 2030 required by China’s State Council. It is necessary to promote breastfeeding and provide maternal breastfeeding guidance to increase exclusive breastfeeding. Factors influencing breastfeeding can be explained by the society ecosystems theory, distributed in macro, mezzo and micro systems. The interventions focused on breastfeeding promotion are mainly carried out in the health systems and services, home and family environment, community environment, work environment, policy environment or a combination of these facilities. But there is sparse research on integrating resources in the macro, mezzo and micro systems of maternal breastfeeding processes to promote breastfeeding behavior. A randomized controlled trial will test the effect of a breastfeeding promotion intervention model based on the society ecosystems theory versus usual prenatal and postnatal care on maternal and infant health and the exclusive breastfeeding rate at 6 months.Methods/designThe study is a single-blind, parallel design, randomized controlled trial with an intervention group (n = 109) and a control group (n = 109) that compares the effect of a breastfeeding promotion intervention model based on the society ecosystems theory with usual prenatal and postnatal care. The intervention covers macro- (policy, culture), mezzo- (family-hospital-community) and micro- (biological, psychological and social) systems of the maternal breastfeeding process. Infant feeding patterns, neonatal morbidity and physical and mental health of antenatal and postpartum women will be collected at baseline (28 to 35 weeks of gestation), 1-, 4-, and 6-month postpartum.DiscussionThis is a multifaceted, multifactorial, and multi-environmental breastfeeding promotion strategy to help mothers and their families learn breastfeeding knowledge and skills. The study provides a new modality for adding breastfeeding interventions to prenatal and postnatal care for healthcare providers in the hospital and the community.Trial registration: Chinese Clinical Trial Registry at www.chictr.org.cn, ChiCTR2300075795.