Shorter Breastfeeding Duration Research Articles

Short Breastfeeding Duration is Associated With Premature Onset of Female Breast Cancer.

Currently, there is controversy concerning potential factors that contribute to the development of breast cancer. Our study analyzed the possible association between weight status, cigarette consumption, lactation period, serum estrogen levels, family history of breast cancer, and age at breast cancer diagnosis. We conducted a retrospective study at a University Hospital in Granada (Spain) by consulting the medical records of 524 women aged 19 to 91 years, all of them diagnosed and treated for breast cancer from 2011 to 2019. Our findings indicated that in non-morbidly obese females who were also non-smokers, a maternal lactation period of more than 3 months (p = .013) and the absence of family antecedents of cancer (p = .025) were statistically significant factors that led to a more advanced age at breast cancer diagnosis. Thus, maternal lactation seems to have a potential protective effect on breast cancer.

Impact of maternal depression and social factors on child’s nutritional status: a case–control study in Egypt

Background Malnutrition is a primary cause of child morbidity. Maternal depression affects children’s health, especially nutrition.Aim This study aimed to explore the effects of maternal depression and social factors on children’s nutrition.Patients and methods A case–control study was carried out on 100 children and their mothers: 50 malnourished children and 50 age-matched and sex-matched healthy-control children. Anthropometric measurements of children were done and transformed into weight-for-age and weight-for-height Z-scores. Screening of depression in mothers was done using Symptom’s Checklist 90-Revised (SCL90-R) Depression dimension. Mini-Mental State Examination (MMSE) was used to assess maternal cognitive functions.Results Thirty-eight percent mothers of malnourished children were depressed compared with 12% mothers of healthy children. The difference was statistically significant (P<0.05). Statistically significant differences were found regarding maternal age at marriage, education, working status, crowding index, and family income between groups (P<0.01). Mothers of malnourished children had cognitive impairment than controls (P<0.001). The Z-score of malnourished children was positively correlated with breastfeeding duration, maternal age at marriage, education, working status, family income, and other social parameters; and negatively correlated with crowding index and gastrointestinal tract (GIT) morbidity, indicating that malnutrition increases with short duration of breastfeeding, younger maternal age at marriage, low education, bad working status, low income, and high crowding index.Conclusions Mothers of malnourished children have more depressive symptoms and impaired cognitive functions than the controls. Maternal age at marriage, education, family income, and crowding index are predictive variables affecting children nutrition.

ПЕРИНАТАЛЬНЫЕ И РОДИТЕЛЬСКИЕ ПРЕДИКТОРЫ ТРАЕКТОРИЙ МАССЫ ТЕЛА И ИНДЕКСА МАССЫ ТЕЛА У КРУПНОВЕСНЫХ ДЕТЕЙ

A dynamic prospective examination of 93 newborn was conducted to study the growth trajectories of anthropometric indicators in large for gestational age newborns in the first two years of life. The differences in the speed of the body weight and body weight gain trajectories in large-bodied children in the two-year period dynamice were revealed, including taking into account the gender trai,. Statistically significantly shorter duration of breastfeeding was established in overweight infants at the age of 2 years. Large for gestational age infants at the 2 years age had advanced growth trajectories starting from 3 months of life. The data obtained substantiate the importance of monitoring the trajectories of anthropometric indicators of a child in the first 2 years of life, with a special emphasis on body mass index in the interval from 3 to 12 months of life.

FEATURES OF CLINICAL SYMPTOMS AND THE INFLUENCE OF RISK FACTORS ON THE OCCURRENCE OF BRONCHIAL ASTHMA IN CHILDREN OF LVIV REGION OF DIFFERENT AGES

Bronchial asthma (BA) is a common chronic pathology of the lower respiratory tract in children. The first manifestations of the disease can begin at any age, but the clinical features, of the course, are different in different periods of childhood. Manifestations and course of asthma may disappear or progress with age. Therefore, it is likely that there are differences in the pathophysiology, inflammatory response of the body and the features of the clinic of asthma in children of different ages, which affects the diagnosis and treatment. The aim of the study was to determine the features of clinical symptoms and the influence of risk factors for asthma on its occurrence in children of different ages.&#x0D; Materials and methods. We analyzed the anamnesis and clinical symptoms of 57 children aged 3 to 18 years, who were treated from September 2020 to June 2021 in the Lviv Regional Children's Clinical Hospital “OHMATDYT” and in the Lviv Municipal City Children's Clinical Hospital. The age groups did not differ statistically in the severity of asthma (P&gt; 0.05). Thus, in group 1 was 1 patient (9.09%) with mild form, 1 patient (9.09%) - moderate persistent form, 8 patients (72.73%) - with severe persistent form. Among patients of age group 2 was 1 patient (3.85%) with mild persistent form, 3 children (11.54%) - moderate and 21 children (80.77%) - with severe persistent form. In group 3 was 1 patient (5%) with a mild persistent form, 6 patients (30%) - moderate and 12 children (80%) - with a severe persistent form. The vast majority of patients were boys (84.21 ± 4.83%). All patients underwent general clinical examinations, spirometry, and allergy tests. We used the clinical-anamnestic method to perform the tasks of the work, which consisted in collecting a detailed somatic and genealogical anamnesis during the parents` questionnaire. Physical development of children was assessed using centile tables. Statistics were evaluated by calculating Student's t-test and Pearson's consistency test. Preschool children with asthma were more likely to experience shortness of breath during exercise and a wet low-yielding cough, and children of primary and secondary school age were more characterized by concomitant allergic rhinitis. Autumn was more unfavorable period for the exacerbation of clinical manifestations of asthma in children of Lviv region was period. We did not find correlation of birth weight on the timing of asthma. However, a burdensome obstetric history contributed to the early development of clinical manifestations of asthma. Preschool children were more likely to be exposed to nicotine during the antenatal period and had a shorter duration of breastfeeding, which may be a probable risk factor for asthma in preschool children. In 77% of children from different age groups were burdened with a history of allergies, with 66% of cases more pronounced in the maternal line. An analysis of physical development revealed that most preschool children were overweight.&#x0D; Conclusions. Asthma has features of clinical symptoms in children of different ages - shortness of breath during exercise and whooping cough are characteristic of preschool children, and concomitant chronic persistent rhinitis - for older age groups. Seasonal exacerbations are characteristic of asthma in children; in particular, the autumn period is more unfavorable, common for asthmatics in children of all ages among patients in Lviv region. Maternal smoking during pregnancy has a significant effect on the risk of developing asthma in children. Also, a burdened maternal allergy history and overweight child contributes to the development of asthma in children.

The importance of sleep and parity in understanding changes in weight and breastfeeding behavior among postpartum women

BackgroundBreastfeeding duration has been linked with the health of both women and their children, but research that considers women's weight change postpartum and practical factors that may impact their quality of life (i.e., sleep quantity, number of children) is limited. MethodA survey was administered to 568 women (M age = 31.32 years; SD = 4.21) who had given birth within the past year. The survey included assessments of pre- and post-pregnancy weight and height, breastfeeding practices, current sleep quantity, presence of breastfeeding-specific support, and other demographics including their total number of children. ResultsGreater pre-pregnancy to postpartum weight increase was related to shorter duration of breastfeeding. Mothers who exclusively breastfed for the first six months had less postpartum weight increase (i.e., the discrepancy between their pre-pregnancy and post-pregnancy weight was smaller) than those who did not. Fewer children and greater hours of sleep were significantly associated with longer duration of breastfeeding. Sleep partially accounted for the relationship between body mass index change and breastfeeding duration. Breastfeeding-specific support did not impact the effect of low sleep on shorter breastfeeding duration. ConclusionsDuration of breastfeeding may suffer due to fatigue. Sleep plays a key role in understanding the ways in which weight change impact breastfeeding behavior. Greater holistic support for mothers in the postpartum period is needed to foster an environment that encourages breastfeeding.

Pregnancy exposure to bisphenol A and duration of breastfeeding

IntroductionBisphenol A (BPA) is frequently used in the production of plastics. It is an endocrine disruptor, and BPA exposure in mice has been associated with reduced offspring growth due to insufficient milk production. However, human studies of associations between BPA exposure and duration of breastfeeding are sparse. MethodsPregnant women from the Odense Child Cohort (n = 725) donated a third trimester morning urine sample, which was analyzed for BPA by LC-MS/MS. Information about duration of exclusive and any breastfeeding was obtained through questionnaires three and 18 months postpartum, and a subgroup of women responded to weekly text messages about breastfeeding. Associations between pregnancy BPA exposure and duration of breastfeeding were analyzed using Cox regression adjusting for potential confounders. ResultsThe median urine BPA concentration was 1.29 ng/mL. Compared to women within the lowest tertile of BPA exposure, women in the second and third tertile were slightly more likely to terminate breastfeeding at any given time; HRs (95% CI) were 1.05 (0.87; 1.26) and 1.06 (0.89; 1.27), respectively, and to terminate exclusive breastfeeding at any time up to 20 weeks after birth, HRs (95% CI) were 1.07 (0.88; 1.28) and 1.06 (0.88; 1.27), respectively. However, confidence intervals were also compatible with no effect or even a protective effect. DiscussionThis study indicated that high BPA exposure in pregnancy was associated with shorter duration of breastfeeding. Although our findings were not statistically significant, all estimates were above one suggesting increased risk of early breastfeeding termination with high exposure. Using a single spot morning urine sample to measure BPA has likely caused imprecision as it might not adequately reflect long term exposure. Future studies should consider measuring BPA more than once, including other timepoints during pregnancy and after birth.

Association of breastfeeding with tidal breathing analysis in infants with bronchiolitis.

BACKGROUNDTidal breathing flow-volume (TBFV) analysis provides important information about lung mechanics in infants.AIMTo assess the effects of breastfeeding on the TBFV measurements of infants who recover from acute bronchiolitis.METHODSIn this cross-sectional study, TBFV analysis was performed in infants with bronchiolitis prior to hospital discharge. The ratio of time to peak expiratory flow to total expiratory time (tPEF/tE) at baseline and after the administration of 400 mcg salbutamol was evaluated.RESULTSA total of 56 infants (35 boys), aged 7.4 ± 2.8 mo, were included. Of them, 12.5% were exposed to tobacco smoke and 41.1% were breastfed less than 2 mo. There were no differences in baseline TBFV measurements between the breastfeeding groups; however, those who breastfed longer than 2 mo had a greater change in tPEF/tE after bronchodilation (12% ± 10.4% vs 0.9% ± 7.1%; P < 0.001). Moreover, there was a clear dose-response relationship between tPEF/tE reversibility and duration of breastfeeding (P < 0.001). In multivariate regression analysis, infants who breastfed less (regression coefficient -0.335, P = 0.010) or were exposed to cigarette smoke (regression coefficient 0.353, P = 0.007) showed a greater change in tPEF/tE after bronchodilation, independent of sex, prematurity, and family history of asthma or atopy.CONCLUSIONInfants who recover from bronchiolitis and have a shorter duration of breastfeeding or are exposed to cigarette smoke, have TBFV measurements indicative of obstructive lung disease.

Effects of Pregnancy and Breastfeeding on Clinical Outcomes and MRI Measurements of Women with Multiple Sclerosis: An Exploratory Real-World Cohort Study.

IntroductionPregnancy represents an important event for women with multiple sclerosis (MS) and is often accompanied by post-partum disease reactivation. To date, the influence of this reproductive phase on long-term MS outcomes is still largely unexplored. The objective of the study was characterise a large real-world cohort of women with MS to evaluate the effects of pregnancy and breastfeeding on short- and long-term clinical and magnetic resonance imaging (MRI) outcomes while exploring the relationships with MRI measurements of brain atrophy.MethodsMS patients with and without pregnancy were recruited. Clinical relapses and MRI activity of the year before conception versus the year after delivery were evaluated. Regression models were performed to investigate the relationships between long-term MS outcomes (EDSS score and MRI brain measurements obtained by SIENAX software) and pregnancy and breastfeeding duration.ResultsTwo hundred ten women with MS were enrolled; of them, 129 (61.4%) had at least one pregnancy. Of all pregnancies (n = 212), those that occurred after MS onset (90 [42.4%]) were examined to evaluate the short-term outcomes. A higher annualised relapse rate in the post-partum year versus the pre-conception year (0.54 ± 0.84 vs. 0.45 ± 0.71; p = 0.04) was observed. A regression analysis showed that clinical activity after delivery was associated with clinical activity of the year before conception (p = 0.001) as well as duration of breastfeeding (p = 0.022). Similarly, post-partum MRI activity was associated with pre-conception MRI activity (p = 0.026) and shorter breastfeeding duration (p = 0.013). Regarding long-term outcomes, having had at least one pregnancy during MS was associated with a lower EDSS score (p = 0.021), while no relationships were reported with MRI measurements. Conversely, a breastfeeding duration > 6 months was associated with lower white matter volume (p = 0.008).ConclusionsOur study underlines the importance of considering the effects of pregnancy and breastfeeding on short- and long-term MS outcomes. In the current therapeutic landscape, pregnancy planning and treatment optimisation in the post-partum period, in particular for women who choose to breastfeed, are fundamental for the management of these biological phases so central in a woman’s life.

Breastfeeding initiation and duration after high exposure to perfluoroalkyl substances through contaminated drinking water: A cohort study from Ronneby, Sweden

BackgroundThe drinking water in parts of Ronneby was heavily contaminated with perfluoroalkyl substances (PFAS) for decades. Although PFAS has endocrine-disrupting properties and may interfere with breastfeeding, the effects in populations with a point source of high exposure are unknown. ObjectivesTo investigate associations between high PFAS exposure and 1) initiation and 2) duration of breastfeeding. MethodsWe retrieved data on infant feeding practices for 2374 children born between 1999 and 2009 from Child Health Care centers in Ronneby and a reference municipality. Residential address before delivery was used as a proxy for exposure, and confounders were obtained from charts and registers. We used modified Poisson regressions to estimate the relative risks (RR) of not initiating breastfeeding, not breastfeeding exclusively after 3 months, and not breastfeeding at all at 6 months. We also estimated hazard ratios (HR) of cessation of exclusive breastfeeding before 6 months and any breastfeeding before 12 months. ResultsMothers who had received contaminated water seemed to have a higher risk of not initiating breastfeeding (RR = 2.4; 95% CI: 0.8, 6.7). Primiparous mothers from the exposed area were at a 1.2 times increased risk (95% CI: 0.9, 1.6) of not exclusively breastfeeding at 3 months and a 1.6 times increased risk (95% CI: 1.2, 2.1) of not breastfeeding at 6 months. The results were confirmed by the Cox regressions, which further showed that the HR for cessation of any breastfeeding was time dependent and higher in early lactation, thereafter decreasing as lactation progressed. We observed no overall associations in multiparous mothers. DiscussionExposure to high levels of PFAS seemed to be associated with increased risks of not initiating breastfeeding and shorter breastfeeding duration in primiparous mothers. The findings imply that the ability of first-time mothers to establish breastfeeding is a sensitive outcome after high exposure to PFAS.

Undernutrition and short duration of breastfeeding association with child development: a population-based study

ObjectiveTo explore the relationship of undernutrition and the short duration of breastfeeding with child development of children 0–66 months of age residing in Ceará, Brazil. MethodsThe authors of the present study utilized population-based data from children enrolled in the Study on Maternal and Child Health in Ceará, Brazil (PESMIC). Children's development was assessed with the Ages and Stages Questionnaire third version, validated in Brazil. Undernutrition was accessed through anthropometric measures obtained by trained staff. Breastfeeding information was obtained through the mothers' report and confirmed in the child's governmental booklet. The authors used logistic regressions adjusted for sample clusters used in PESMIC design in a theoretical model for known determinants of child development following the World Health Organization nurturing framework. ResultsA total of 3,566 children were enrolled in the sixth PESMIC study and had their development assessed. The authors found that 8.2%, 3.0%, 2.1%, and 3.6% of children were stunted, underweight, or wasted, at the time of the interview, respectively. All studied factors were associated with a higher prevalence of child development impairment in at least one of the assessed domains. Underweight was the factor with the strongest effect, with an adjusted odds ratio (AOR) of 4,14 (2,26–7,58), p < 0.001. Breastfeeding for up to two months compared to more than six months (AOR 2,08 (1,38–3,12)) was also associated. ConclusionsThe authors found that undernutrition and short duration of breastfeeding are associated with development outcomes among Brazilian children. As a result, integrated nutritional programs may improve child development outcomes.

Prevalence, Risk Factors, Clinical Manifestation, Diagnosis Aspects and Nutrition Therapy in Relation to both IgE and IgG Cow’s Milk Protein Allergies among a Population of Saudi Arabia: A Literature Review

Cow milk protein allergy (CMPA) becoming a major public health issue that has attracted the attention of health professionals and researchers. This paper aimed to review the important aspects of both IgE and IgG types of cow’s milk protein allergy in terms of prevalence, clinical manifestation, risk factors, other health-related issues and nutritional therapy proposed for such allergies in the adult and pediatric population in Saudi Arabia. A search on “cow’s milk allergy” was done using PubMed, Google Scholar and Scopus Engine for published papers between 1993 and 2020 to find studies yielding knowledge on that context. The prevalence of cow’s milk protein allergy (CMPA) among infants is now in the range of 2–3%. This type of allergy is also detected in adulthood but less frequently. CMPA is defined as an immunological reaction to specific proteins in milk. CMPA is classified based on its type as an immunoglobulin E (IgE)-mediated form and an immunoglobulin G (IgG)-mediated form, each type representing different immunological pathways. The presence of Genetic aspects, family history and short duration of breastfeeding in the infant are among the risk factors contributing to this form of allergy. Its manifestations mainly present as skin presentation, followed by the gastrointestinal and respiratory presentation in most cases in addition to a life-threatening anaphylactic reaction that may occur in 12% of cases. food allergy committees have developed strict diagnosis criteria, including blood testing for food-specific immunoglobulin E (sIgE), a skin prick test and double-blind placebo-controlled food challenges (DBPCFC) as the gold standard. A diet free of cow’s milk protein (CMP) allergen and including the appropriate alternative milk formula is the first line of prevention recommended by many organizations and food allergy experts. As for Saudi Arabia, more research and clinical trials are required to discuss the various aspects of adult and pediatric CMPA and to provide a better understanding along with good control strategies implementation.

Diet quality of Norwegian children at 3 and 7 years: changes, predictors and longitudinal association with weight.

Poor diet quality in early life can have long-term health effects, but the evidence is largely from cross-sectional studies. Our objective was to examine diet quality of Norwegian children by applying a-priori diet quality indices, identify early life determinants and examine prospective associations with overweight. We included 34,074 preschoolers (3-year-olds) and 18,350 school-aged children (7-years-olds) from the prospective, population-based Norwegian Mother, Father and Child Cohort Study. Diet quality was assessed as (i) adherence to a Mediterranean diet, estimated by the food frequency-based Mediterranean Diet Score (fMDS, score range: 0-6) and (ii) by the diet quality index (DQI, score range: -33% to 100%), reflecting compliance to food-based dietary guidelines. In multivariate analyses we explored perinatal and childhood characteristics as potential determinants of diet quality. We used logistic regression to examine the associations between diet quality at 3 years and BMI status at 8 years, adjusting for relevant confounders and diet quality at 7 years. One in three children had high MD adherence at 3 and 8 years, and DQI (mean 60%) at 3 and 7 years was strongly correlated (r = 0.48, p < 0.001). Short breastfeeding duration, physical activity and sleep duration and long screentime at 18 months were associated with 2-3% lower DQI at 3 years. At both ages, maternal diet quality was the strongest prospective predictor of DQI (beta = 5%, 95% CI = 4.7, 5.2 and beta = 3.1%, 95% CI = 2.8, 3.4), and screentime was the strongest cross-sectional predictor (beta = -5.2%, 95% CI = -5.9, -4.5 and beta = -4.1%, 95% CI = -5.0, -3.2). High DQI score at 3 years, but not MD adherence, was associated with a lower risk for overweight (including obesity) at 8 years, compared to low DQI (lower tertile) (adjusted OR = 0.77, 95% CI = 0.62, 0.96). Our study provides evidences that high diet quality in early childhood may reduce the risk for overweight in later childhood, independent of the current dietary behaviors.

Breastfeeding Initiation and Duration after High Exposure to Perfluoroalkyl Substances through Contaminated Drinking Water: A Cohort Study from Ronneby, Sweden

BACKGROUND AND AIM: The drinking water in parts of Ronneby municipality was heavily contaminated with perfluoroalkyl substances (PFAS) for decades. Although PFAS has endocrine-disrupting properties and may interfere with breastfeeding, the supporting epidemiologic literature is conflicting and based solely on populations with background levels of exposure. The effects on breastfeeding in populations with a point source of exposure are unknown. The aim was to investigate the potential associations between high PFAS exposure and 1) initiation and 2) duration of breastfeeding in a population-based cohort. METHODS: We retrieved data on infant feeding practices for 2,374 children born between 1999 and 2009 from Child Health Care centers in Ronneby and Karlshamn, a nearby municipality with background levels of exposure. Maternal residential address before delivery was used as a proxy for exposure, and confounder data were obtained from charts and national registers. We used modified Poisson regressions to estimate the risk of not initiating breastfeeding and, among initiators, the risks of not breastfeeding exclusively after 3 months and not breastfeeding at all at 6 months. RESULTS:Mothers who had received the contaminated water at their residential address had a 2.4 times higher risk (95% CI: 0.8, 6.7) of not initiating breastfeeding. Among initiators, primiparous mothers from the exposed area were at a 1.2 times increased risk (95% CI: 0.9, 1.6) of not exclusively breastfeeding at 3 months and a 1.6 times increased risk (95% CI: 1.2, 2.1) of not breastfeeding at all at 6 months. Multiparous women seemed less vulnerable to these effects, although we observed slightly increased risk estimates towards the end of the study period. CONCLUSIONS:Exposure to high levels of PFAS was associated with increased risks of not initiating breastfeeding as well as with shorter breastfeeding duration. Initiation among primiparous mothers was the most critical outcome, and targeted intervention might be warranted. KEYWORDS: PFAS, Long-term exposure, Reproductive Outcomes, Environmental Epidemiology

Strengths and difficulties in children with specific learning disabilities.

The study aims to investigate the social, emotional, and behavioral challenges in children with a specific learning disability (SLD) and to identify the factors that accompany these problems by screening with the Strengths and Difficulties Questionnaire (SDQ). The descriptive study was conducted on 278 children with SLD. Strengths and difficulties in children were evaluated by the SDQ applied to their mothers. The percentage of cases above the cut-off limits of the SDQ was calculated. Chi-square test and multiple logistic regression analysis were used for analysis. The mean (SD) total SDQ score was 15.8 (6.5). The percentage of scores of abnormal total difficulties in SLD was 47.8%. Multivariate analysis revealed that cases exposed to antenatal smoking had higher odds ratio of abnormal emotional symptoms and abnormal total difficulties; cases with poor familial income and the presence of a history of antenatal smoking exposure showed considerably higher odds ratio of conduct problems; cases with younger age at the diagnosis of SLD, dyscalculia, extreme duration of preschool screen time (≥4h), and history of hospitalization had significantly higher odds ratio for hyperactivity-inattention problems; and cases having shorter breastfeeding duration had higher odds ratio of peer problems compared to counterparts. Children with SLD have a high score on the SDQ. Practitioners could especially give guidance and support to families with financial problems and those having a child with an early age at diagnosis, exposure to antenatal smoking, short breastfeeding period, early age of the first screen use, and long screen exposure duration during the preschool period.

Increased infectious-cause hospitalization among infants who are HIV-exposed uninfected compared with HIV-unexposed.

Increased risk of morbidity and hospitalization has been observed in children who are HIV-exposed uninfected (HEU) compared with HIV-unexposed uninfected (HUU). Studies in the era of universal maternal antiretroviral treatment (ART) are limited. Prospective cohort. We investigated hospitalization between 29 days and 12 months of life in a South African cohort of infants born between February 2017 and January 2019 (HEU = 455; HUU = 458). All mothers known with HIV during pregnancy received ART. We reviewed hospital records and classified and graded infectious diagnoses using a standardized tool. We examined factors associated with infectious-cause hospitalization using mixed-effects Poisson regression. Infants HEU vs. HUU had higher all-cause and infectious-cause hospitalization (13 vs. 7%, P = 0.004 and 10 vs. 6%, P = 0.014, respectively). Infectious causes accounted for most hospitalizations (77%). More infants HEU were hospitalized with severe or very severe infections than those HUU (9 vs. 6%; P = 0.031). Mortality (<1%) did not differ between groups. HIV exposure was a significant risk factor for infectious-cause hospitalization [adjusted incidence rate ratios (aIRRs) = 2.8; 95% confidence interval (CI) 1.5-5.4]. Although increased incidence of preterm birth (14 vs. 10%; P < 0.05) and shorter duration of breastfeeding (44 vs. 68% breastfed for ≥3 months, P < 0.001) among infants HEU vs. HUU contributed to increased hospitalization, they did not account for all the increased risk. Infectious-cause hospitalization incidence was higher among infants HEU vs. HUU, likely partly because of higher incidence of preterm birth and lower breastfeeding rates among infants HEU. The increased infectious disease burden in HEU infants has important implications for health services in sub-Saharan Africa.

The causal effect and impact of reproductive factors on breast cancer using super learner and targeted maximum likelihood estimation: a case-control study in Fars Province, Iran

ObjectivesThe relationship between reproductive factors and breast cancer (BC) risk has been investigated in previous studies. Considering the discrepancies in the results, the aim of this study was to estimate the causal effect of reproductive factors on BC risk in a case-control study using the double robust approach of targeted maximum likelihood estimation.MethodsThis is a causal reanalysis of a case-control study done between 2005 and 2008 in Shiraz, Iran, in which 787 confirmed BC cases and 928 controls were enrolled. Targeted maximum likelihood estimation along with super Learner were used to analyze the data, and risk ratio (RR), risk difference (RD), andpopulation attributable fraction (PAF) were reported.ResultsOur findings did not support parity and age at the first pregnancy as risk factors for BC. The risk of BC was higher among postmenopausal women (RR = 3.3, 95% confidence interval (CI) = (2.3, 4.6)), women with the age at first marriage ≥20 years (RR = 1.6, 95% CI = (1.3, 2.1)), and the history of oral contraceptive (OC) use (RR = 1.6, 95% CI = (1.3, 2.1)) or breastfeeding duration ≤60 months (RR = 1.8, 95% CI = (1.3, 2.5)). The PAF for menopause status, breastfeeding duration, and OC use were 40.3% (95% CI = 39.5, 40.6), 27.3% (95% CI = 23.1, 30.8) and 24.4% (95% CI = 10.5, 35.5), respectively.ConclusionsPostmenopausal women, and women with a higher age at first marriage, shorter duration of breastfeeding, and history of OC use are at the higher risk of BC.

Examining patterns of postnatal feeding in relation to infant's weight during the first year

BackgroundThere is mixed evidence regarding specific infant feeding behaviors and later risk for overweight and obesity. We sought to detect underlying patterns in duration of breastfeeding, introduction of solid foods and sweetened beverages, in order to understand the relation to later weight. MethodsPatterns of postnatal feeding were examined among infants enrolled in the Infant Feeding Practices Study II (N = 3033). At monthly intervals, mothers reported on the duration of any and exclusive breastfeeding, age of solid food and sweetened beverage introduction, and reported infant weight at ages 9- and 12-months. Latent profile analysis was used to empirically derive patterns of postnatal feeding and examine associations with weight z-scores at 9 and 12 months. ResultsTwo profiles emerged: (1) Short breastfeeding duration and early introduction to solid foods and sweetened beverages (Short BF/Early Introduction; 53%) and (2) longer breastfeeding duration and later introduction to solid foods and sweetened beverages (Longer BF/Later Introduction; 43%). Infants in the Shorter BF/Early Introduction profile had significantly greater weight z-scores at 9 (M = 0.18) and 12 months (M = 0.26), compared to those in the Longer BF/Later Introduction profile (M = −0.21; M = −0.17, respectively). ConclusionsOverall, shorter BF duration and earlier food and sweetened beverage introduction is associated with higher weight z-scores at 9 and 12 months. Early intervention should aim to promote breastfeeding and later introduction of solids and discourage consumption of sweetened beverages. These postnatal patterns of feeding behaviors provides important context to inform targeted interventions aimed at reducing risk for later obesity.

Prevalence and Factors Associated with Under Nutrition among Children Aged 6 to 59 Months in Ngoma District, Rwanda

In Rwanda, 38% children aged 6-59 months are stunted. In Ngoma District, stunting rate is estimated at 41% among the children aged below 5 years. The study objective was to evaluate the prevalence and factors contributing to under nutrition among children aged 6- 59 months in Ngoma District. Cluster sampling was used to determine the study participants for each sector within 14 sectors by considering the sample size of 442. The WHO Anthro software version 3.2.2 was used to determine the nutritional status of the children. SPSS version 24 was used for analysis. Of 442 children participated in the study 50.9% of them were females, 24.4% were aged 15-23 months and the majority of children (89.8%) born with normal birth weight. Study findings revealed that the prevalence of under nutrition was 33.7% for stunting, 3.6% for wasting and 6.6% underweighted. Poor sanitation facility (AOR: 4.1, 95%CI: 1.83-9.3, p=0.001), poor diet (AOR: 1.9, 95%CI: 1.18-3, p=0.008) were significantly associated with stunting. Factors such as lack of hand-washing facilities (AOR: 2.5, 95% CI: 1.013-6.3, p=0.047), not eat vegetables (AOR: 4.4, 95%CI: 1.7-10.96, p=0.001), and not eat fishes (AOR: 4.1, 95%CI: 1.6-10.6, p=0.003) were associated with wasting. Short breastfeeding duration (AOR: 4.5, 95%CI: 2.9-7.2, p=0.001), not eat vegetables (AOR: 1.9; 95%CI: 1.1-3.05, p=0.008), and not eat eggs (AOR: 2, 95%CI: 1.3-2.9, p=0.001) were associated with underweight. Poor families with under-five children need continuous support that will assist them to improve nutritional status of their children.

Reproductive and menstrual factors for papillary thyroid cancer risk: A case-control study in Chinese women

BackgroundThyroid cancer (TC) is threefold more common in women than men. Reproductive and menstrual factors may be related to the onset of papillary thyroid cancer (PTC). This study aims to determine the association of reproductive and menstrual factors with PTC in Chinese females. MethodsA total of 335 histologically confirmed cases of PTC were recruited in this case-control study. The controls were matched for age with a deviation of ± 2 years, which conducted from September 2016 to February 2019. Logistic regression models were applied to identify the association of reproductive and menstrual factors with PTC. ResultsAfter adjustment by some variables, early menarche age (OR ≤ 13 years vs. > 13years = 2.40, 95 % CI 1.12−5.13) and shorter lifetime breastfeeding (OR <6 months vs. ≥ 6 months = 1.99, 95 % CI 1.11−3.55) significantly increased the risk of PTC, whereas younger age at first pregnancy had a protective effect against PTC (OR ≤ 24years vs. > 24 years = 0.66, 95 % CI 0.44−0.98). There was a positive correlation between premenopausal and PTC in the lower age group (OR premenopausal vs. Menopause by natural =2.34, 95 %CI 1.03−5.28). ConclusionsEarly menarche age, abortion, shorter breastfeeding duration and premenopausal may be related to the occurrence of PTC. Early age at first pregnancy and larger number of full-time pregnancies were possible to decrease the risk of PTC.

582-P: Gestational Diabetes and Breastfeeding: Evidence from PRAMS

Gestational diabetes (GD) disproportionately affects American Indian and Alaska Native (AI/AN) women, who are nearly twice as likely to experience GD as non-Hispanic White women. Despite the well-established benefits associated with breastfeeding, including reduction of risk of type 2 diabetes, women who develop GD are frequently less likely to breastfeed than women who do not develop GD. AI/AN women are less likely to initiate breastfeeding and breastfeed for a shorter duration compared to other women. No previous study has evaluated the potential link between GD and breastfeeding outcomes among AI/AN women. The purpose of this study was to examine the relationship between GD and breastfeeding among women of different ethnicities in four states using the Pregnancy Risk Assessment Monitoring Surveillance (PRAMS). We used data from Phase 8 (2016-2018) of PRAMS from Alaska, Oklahoma, South Dakota, and Washington. We used logistic regression to estimate factors associated with breastfeeding initiation for each group of women, conducted survival analysis using Kaplan Meier curves, and Cox proportional hazards regression to analyze duration of breastfeeding. Twelve percent of AI/AN and Hispanic women had GD in their most recent pregnancy, compared to less than 9 percent among non-Hispanic White and non-Hispanic Black women (p&amp;lt;0.0001). AI/AN women were the least likely to initiate breastfeeding compared to other women (85% vs. 88-93%, p&amp;lt;0.0001) and the least likely to be breastfeeding at the time of survey (51% vs. 57-69%, p&amp;lt;0.0001). While there was no association between GD and initiation of breastfeeding, women who had GD had a shorter duration of breastfeeding compared to women who did not have GD. GD significantly modifies the association between race/ethnicity and breastfeeding duration. Increasing support for AI/AN women with GD to initiate and continue breastfeeding may represent an effective and culturally appropriate intervention to improve maternal and child health outcomes and reduce disparities. Disclosure L. E. Hebert: None. C. J. Nikolaus: None. A. Zamora-kapoor: None. K. Sinclair: None. Funding National Institute of Diabetes and Digestive and Kidney Diseases (P30DK092923)