Shorter Duration Of Exclusive Breastfeeding Research Articles

"It's Okay With Our Culture but We're in a Different Place and We Have to Show Respect": Marshallese Migrants and Exclusive Breastfeeding Initiation.

Pacific Islanders in the United States have lower initiation rates and shorter duration of exclusive breastfeeding compared to other racial/ethnic groups. To describe infant feeding beliefs and experiences of Marshallese living in the United States. We used a prospective and cross-sectional exploratory, descriptive qualitative design with Marshallese participants (N = 36) residing in the United States between July 2019 and July 2020. Data were collected at 6-8 weeks postpartum. Our qualitative analytic approach integrated inductive and deductive techniques. Participants' mean age was 27.1 years (SD = 6.1), and 88.9% (n = 32) were born in the Marshall Islands. A majority of participants were single, widowed, or in an unmarried partnership (n = 28, 77.8%). Most participants had a high school education or lower (n = 30, 83.3%). Mean household size was 7.2 (SD = 2.8). Fewer than half of participants had no health insurance (n = 14, 38.9%), and almost all participants (91.7%) did not work at the time of data collection. Two themes emerged: 1) infant feeding initiation and practices; and 2) concerns over breastfeeding in public. The majority of participants' infants received both human milk and formula. Participants described beliefs that breastfeeding in public was against American customs, which influenced their decision about breastfeeding in public. Our study was the first to document infant feeding beliefs and experiences of Marshallese living in the United States at 6-8 weeks postpartum. Findings will inform future health education programs.

Why does mode of conception affect early breastfeeding outcomes? A retrospective cohort study.

IntroductionIt is uncertain whether Assisted Reproductive Technology (ART) is associated with an increased risk of poor breastfeeding outcomes and what could be possible mechanisms. This study aimed to examine the effect of mode of conception on breastfeeding outcomes during the first two months postpartum and identify the potential mediating pathways for this relationship.MethodsA retrospective cohort study was conducted in a sample of 3,565 women with live births. Participants were classified by mode of conception as follows: fertile women who conceived naturally (fertile women; n = 2,857), women with infertility who conceived naturally (sub-fertile women; n = 483), and women with infertility who conceived through ART (women with infertility; n = 310). The infant-feeding patterns were assessed with four-time points before two months postpartum. Binary and multinomial logistic regression and causal mediation analyses were performed.ResultsThe rates of breastfeeding initiation and discontinuation across modes of conception were similar. However, infertile and sub-fertile women had 37% (95% CI 1.02, 1.83) and 56% (95% CI 1.06, 2.27) increased risks of introducing formula before the first week postpartum, respectively, and 35% (95% CI 1.01, 1.82) and 52% (95% CI 1.04, 2.24) higher risks of exclusive breastfeeding for less than one week, respectively, compared to fertile women. The relationships were mainly mediated through multiple gestation and admission to neonatal/pediatric intensive care units (NICU/PICU; proportions of mediation were over 50%). The effects of mode of conception on breastfeeding outcomes became not significant in cases of singleton birth.ConclusionsSub-fertile women and women with infertility intended to breastfeed but experienced higher perinatal risks in the early postpartum period. Multiple gestation and admission to NICU/PICU forced them to introduce formula earlier than preferred, thus leading to a shorter duration of exclusive breastfeeding. Single embryo transfer policy and breastfeeding support in NICU/PICU could help those women achieve positive early breastfeeding outcomes.

Intestinal Colonization With Bifidobacterium longum Subspecies Is Associated With Length at Birth, Exclusive Breastfeeding, and Decreased Risk of Enteric Virus Infections, but Not With Histo-Blood Group Antigens, Oral Vaccine Response or Later Growth in Three Birth Cohorts.

Bifidobacterium longum subspecies detected in infant stool have been associated with numerous subsequent health outcomes and are potential early markers of deviation from healthy developmental trajectories. This analysis derived indicators of carriage and early colonization with B. infantis and B. longum and quantified their associations with a panel of early-life exposures and outcomes. In a sub-study nested within a multi-site birth cohort, extant stool samples from infants in Bangladesh, Pakistan and Tanzania were tested for presence and quantity of two Bifidobacterium longum subspecies. The results were matched to indicators of nutritional status, enteropathogen infection, histo-blood group antigens, vaccine response and feeding status and regression models were fitted to test for associations while adjusting for covariates. B. infantis was associated with lower quantity of and decreased odds of colonization with B. longum, and vice versa. Length at birth was associated with a 0.36 increase in log10 B. infantis and a 0.28 decrease in B. longum quantity at 1 month of age. B. infantis colonization was associated with fewer viral infections and small reductions in the risk of rotavirus and sapovirus infections, but not reduced overall diarrheal disease risk. No associations with vaccine responses, HBGAs or later nutritional status were identified. Suboptimal intrauterine growth and a shorter duration of exclusive breastfeeding may predispose infants to early intestinal colonization with the B. longum subspecies at the expense of B. infantis, thus denying them potential benefits of reduced enteric virus episodes.

Maternal occupation and the duration of exclusive breastfeeding: results of a birth cohort in São Luís, in the State of Maranhão, Brazil

In investigations determining the duration of exclusive breastfeeding (EBF), the variable paid maternal work is mostly dichotomized into no and yes. This study analyzes possible associations between the characteristics of maternal occupation and shorter EBF duration. A cohort study was conducted in a systematic sample of births in the city of São Luís (State of Maranhão, Brazil), in 2010. The variables type of maternal occupation, numbers of days worked/week and hours worked/day, if they work while standing for most of the time, and if they lift heavy objects at work were collected with 5,166 mothers of live births. The final sample of this study had 3,268 observations. Survival analysis was used to evaluate associations between variables and EBF outcomes up to 4 months (EBF4) and EBF up to 6 months (EBF6). Not having paid work was the reference category. Adjusted Cox regressions showed that mothers with semi-specialized manual work (95% confidence interval, 95%CI: 1.02-1.58 for EBF4 and 95%CI: 1.11-1.56 for EBF6) and mothers who worked 8 or more hours daily (95%CI: 1.01-1.36 for AME4 and 95%CI: 1.11-1.41 for ESA6) more frequently discontinued EBF. Mothers with in-office occupations (95%CI: 1.07-1.46), who worked 4-5 days (95%CI: 1.01-1.36) or 6-7 days/week (95%CI: 1.09-1.40) and for 5-7 hours (95%CI: 1.03-1.43) also practiced less EBF6. Working (95%CI: 1.08-1.40) or not (95%CI: 1.03-1.34) while standing for most of the workday and lifting (95%CI: 1.07-1.56) or not (95%CI: 1.06-1.33) heavy objects at work decreased the duration of EBF6. Types of occupation and working time interfered more frequently in the duration of EBF6.

Prevalence and factors associated with undernutrition among Dayak children in rural areas of Sarawak, Malaysia

Background: Undernutrition among children has become a major public health issue due to the high risk of morbidity and mortality involving this vulnerable age group. This study focused on the rural population, especially among the Dayak children in Sarawak, Malaysia. Methodology: This community-based cross-sectional study was conducted in Sarawak’s rural areas using a multistage stratified cluster sampling technique. Data were collected through face-to-face interviews using an interviewer-guided questionnaire. The nutritional status of the under-five children was measured according to the World Health Organization guidelines. The nutritional indicators were calculated as z-scores. Multivariate logistic regression analyses were performed using SPSS to identify the factors associated with nutritional status. Results: The prevalence of undernutrition among the under-five Dayak children in the rural areas of Sarawak was 39.6%. The analysis suggested that wasting was predominantly associated with parental education levels of primary and below, poor wealth index, environmental and sanitation issues, children with history of low birth weight, shorter duration of exclusive breastfeeding, and poor appetite. Stunting was high within the age group of <3 years old and was associated with parents’ occupation and household wealth index. Low parental education, poor wealth index, environmental and sanitation issues, poor appetite, and the children’s recent illness predicted underweight. Conclusion: These findings imply that a multi-sectoral and multi-dimensional approach is essential to address undernutrition in rural settings. Improvement on households’ socioeconomy, environment and sanitation should be emphasised to reduce undernutrition among the children.

Infant feeding and internalized stigma: The role of guilt and shame

AbstractGlobally the rates of breastfeeding duration are extremely low and postnatal mental health issues are common. As a result, it is important to examine the emotions that underlie these matters. Across two studies (one correlational study N = 160 and one experimental study N = 118), we examined participants’ experiences of shame and guilt when feeding their baby, and the relationship between these emotions with breastfeeding behaviors and internalized stigma. We also examined the psychosocial factors that predict internalized stigma, and whether shame and guilt mediate these relationships. We focused on three factors that have been shown to be associated with internalized stigma in other domains: self‐esteem and social support (Study 1), as well as self‐efficacy (Study 2). Multiple regression revealed that experienced guilt uniquely predicted a shorter duration of exclusive breastfeeding (Study 1). Higher self‐efficacy (Study 2), self‐esteem, and perceived social support (Study 1) predicted lower internalized stigma of feeding choice. We found that shame was a mediator for the self‐esteem and internalized stigma relationship (Study 1), while guilt was a mediator for the self‐efficacy and internalized stigma relationship (Study 2). Our findings highlight the importance of experienced shame and guilt in mothers’ infant feeding experiences. The current results can inform future research and the design of interventions to improve breastfeeding rates and reduce feelings of stigma.

Early onset of overweight among children from low-income families: The role of exclusive breastfeeding and maternal intake of ultra-processed food.

There is an increasing prevalence of overweight during early childhood in the most impoverished areas in Brazil, although there is a lack of evidence regarding its onset. To investigate the incidence and risk factors associated with overweight among low-income children during their first year of life. We analysed data from a prospective birth cohort study conducted in Brazil, which followed-up children at birth, 3rd, 6th and 12th months (n=196). The overweight incidence (zBMI/A > 2SD) was analysed using the Kaplan-Meier survival estimator and its associated factors by the Coxs regression model. Missing data were addressed with multiple imputations and results on the final adjusted model were calculated by pooling the estimates generated for each imputed dataset. The overweight incidence was 17 events/100 children-year, and most cases occurred before the 6th month. The final model showed that children exclusively breastfed up to 30 days (vs. >30 days; HR 2.68; 95%CI 1.11-6.49) and whose mothers consumed ultra-processed foods more than 4 times/day (vs. ≤4 times/day; HR 3.02; 95%CI 1.28-7.13) presented a higher risk of developing overweight. The overweight incidence was high in this impoverished population. Shorter exclusive breastfeeding duration and an unhealthy household food environment provided a short-term risk increase.

HUBUNGAN BODY IMAGE TERHADAP PERILAKU PEMBERIAN ASI EKSKLUSIF PADA IBU PEKERJA

A negative body image after childbirth tends to have a shorter duration of exclusive breastfeeding due to postpartum diet, embarrassment at having to breastfeed in public and concerns about the impact of breastfeeding on body shape. Government policies and regulations supporting exclusive breastfeeding in the workplace are not yet maximum because there are many workplaces that do not support the exclusive breastfeeding program, including time off for maternity leave, places for expressing breastmilk. This research is an observational non-experimental study using an analytical design that is case sectional. Sampling in this study used a purposive sampling technique with 70 respondents at the Meurah Mulia Public Health Center, Meurah Mulia District, North Aceh Regency in 2020. Data collection was carried out through a questionnaire. The univariate data analysis technique used frequency distribution and bivariate analysis used the chi-square test. The results showed that the majority of body image with breastfeeding behavior supported body image with positive breastfeeding behavior as many as 56 respondents (80%). There is a relationship between body image and exclusive breastfeeding behavior for working mothers at Meurah Mulia Public Health Center, Meurah Mulia District, North Aceh Regency in 2020 with a value of p (0.002) <p value (0.05), it is hoped that respondents will continue to add information and knowledge, especially regarding behavior Exclusive breastfeeding.

Factors associated with Exclusive Breastfeeding in Tunisian population

Abstract Background Breastfeeding (BF) is one of the most effective ways to ensure child health and survival. WHO recommend the maintaining the exclusive breastfeeding (EB) up to six months. Unfortunately, its prevalence does not exceed 13% in our country at this age. A better understanding of factors associated with short duration of breastfeeding can allow us to identify the strategies that improve it. This study aimed to determine prevalence of EB and predominant breastfeeding (PB) during the first 2 months and identify their associated factors. Methods We conducted an observational prospective study in two centers of maternal and child health of Monastir (Tunisia) during April and May 2019. Data collection was performed after birth using a self-administered questionnaire and at 4th and 8th postpartum week by telephone interviews. We used the BSES-SF scale to identify self-efficacy in BF and the IIFAS-A scale to measure the mother's attitude towards BF. We used Kaplan Meier survival analysis and Cox Proportional Hazard regression to identify independent factors associated with EB and PB. Results During the study, 437 mothers were enrolled. Prevalence at 8th postpartum week was 6.2% with median duration of eight days and 35.6% with median duration of 21 days respectively for EB and PB. Absence of a breastfeeding experience (HR = 1.31 [1.07-1.61], p = 0.008), the first breastfeeding at beyond 12 hours (HR = 1.47 [1.05-2.07], p = 0.023), the intention of mixed breastfeeding (HR = 1.25 [1- 1.55], p = 0.043) were associated with a shorter duration of EB. Absence of breastfeeding experience (HR = 1.47 [1.05-2.07], p = 0.023), the first breastfeeding at beyond 2 hours (HR1 = 1.72 [1.08-2.73]; p = 0.007) and the non-determination of the duration of breastfeeding (HR = 1.54 [1.43-4.51], p = 0.006) were associated with a shorter duration of PB. Conclusions This study allowed us to identify mothers likely to stop BF early. They should be the target of specific promotion interventions. Key messages Breastfeeding is one of the most effective ways to ensure child health and survival. Information about BF, time of first BF, type and duration of planned BF and self-efficacy deserve a particular attention and constitute key axes of effective promotion interventions of EB and PB.

The Impact of Working Outside the Home on Breastfeeding in Michigan’s Upper Peninsula

Abstract Objectives Working outside of the home is associated with a shorter duration of exclusive breastfeeding (EBF). It is unclear if this relationship exists in rural populations where the workplace environments may differ. Michigan's Upper Peninsula (U.P) is an exclusively rural region with limited access to medical services, which varies greatly across the 15 U.P. counties. According to Michigan Vital Statistics, initiation of breastfeeding across the 15 U.P. counties is low, (range 13–82%, median 44%). We explored the relationship between maternal employment outside the home and a) EBF at 6 months and b) duration of EBF in the U.P. Methods This study is a secondary analysis of a cross sectional study conducted in 2017–18. Mothers of children <5 years old residing in the U.P were eligible to complete a self-administered survey. The outcomes of interest were EBF at 6 months (Y/N) and duration of EBF (months). The primary exposure was working outside the home (Y/N) during the baby's first year. Logistic regression was used to assess the association between working outside the home and EBF at 6 months (SAS v. 9.4). An Analysis of Covariance (ANCOVA) was used to compare the duration of EBF among mothers who worked outside the home in the first year to those who did not. Confounders were retained in each fully-adjusted model if the odds ratio (logistic model) or coefficient of the primary exposure (ANCOVA) changed by >10% using forward selection. Results After adjustment for mother's education, age, and delivery distance, in the logistic model, mothers who went back to work are less likely to EBF for ≥6 months compared to mothers who did not. These results were not statistically significant (OR = .718, 95% CI: 0.39, 1.33). Adjusting for these and household income, and birth class attendance, in the ANCOVA model, there is a 0.39 month increase in EBF duration for every additional month she stays home (p-value = 0.03). Conclusions This data shows that in the U.P., a rural region with limited lactation services, working outside the home in the first year after birth negatively impacts length of EBF. Although this is a similar trend as seen in urban populations, the reasons for the relationship may differ in rural areas suggesting the need for place-based policy for breastfeeding support in workplaces. Funding Sources MTU Pavlis SURF Grant, Portage Health Foundation.

Effect of Pathological Gestational Weight Gain on Subsequent Lactation

The onset, duration of lactation and exclusive breastfeeding (BF) depend on maternal factors. Objective: The aim of our study was to investigate the effect of pathological gestational weight gain (GWG) on subsequent lactation. Design: This was a prospective cohort study of 219 women, aged 18 to 43 years, who were enrolled at 9-11 weeks and were followed-up at 22-24, 37-39 weeks of pregnancy, and 1 year postpartum. Anthropometry, body mass index, GWG were calculated. The percentage of body fat mass (% FM) was calculated on the basis of bioelectrical impedance analysis (BIA) using the “Diamant-aist” analyzer (St. Petersburg). The delayed onset of lactation (more than 72 hours), the duration of lactation, exclusive BF were interviewed. The results were statistically analyzed using statistical analysis package based on Microsoft Excel and Statistica 6.0 program pack (StatSoft Inc., USA). Results: The total BF and exclusive BF median durations were 29.7±10.1 (95% Cl 25.7-33.7) weeks and 22.2±6.2 (95% Cl 18.2-26.2) weeks, respectively. A negative association between the elevation of the %FM during pregnancy and the duration of BF (r= - 0.21, p=0.001; r= - 0.32, p<0.0001; r=- 0.47, p<0.0001, respectively in the first, second and third trimesters) was diagnosed. It has been proved that excessive GWG was significantly associated with shorter duration of lactation (p<0.05), with shorter duration of exclusive BF (OR 0.5; 95% Cl 0.2-0.9, p=0.03), with increased chances of discontinuing BF before 6 month postpartum (OR 2.2; 95% Cl 1.0-4.5, p=0.04), and delayed onset of lactation (OR 2.1; 95% Cl 1.1-4.1, p=0.04) compared with the recommended GWG women. Conclusion: Informing the pregnant women about the negative effect of pathological GWG on subsequent lactation, regular assessing the dynamics of weight gain during pregnancy, and taking measures to prevent overweight and obesity in the postpartum period should be an important focus of antenatal care.

Determinants of Campylobacter infection and association with growth and enteric inflammation in children under 2 years of age in low-resource settings

Campylobacter species infections have been associated with malnutrition and intestinal inflammation among children in low-resource settings. However, it remains unclear whether that association is specific to Campylobacter jejuni/coli. The aim of this study was to assess the association between both all Campylobacter species infections and Campylobacter jejuni/coli infections on growth and enteric inflammation in children aged 1–24 months. We analyzed data from 1715 children followed from birth until 24 months of age in the MAL-ED birth cohort study, including detection of Campylobacter species by enzyme immunoassay and Campylobacter jejuni/coli by quantitative PCR in stool samples. Myeloperoxidase (MPO) concentration in stool, used as a quantitative index of enteric inflammation, was measured. The incidence rate per 100 child-months of infections with Campylobacter jejuni/coli and Campylobacter species during 1–24 month follow up were 17.7 and 29.6 respectively. Female sex of child, shorter duration of exclusive breastfeeding, lower maternal age, mother having less than 3 living children, maternal educational level of <6 years, lack of routine treatment of drinking water, and unimproved sanitation were associated with Campylobacter jejuni/coli infection. The cumulative burden of both Campylobacter jejuni/coli infections and Campylobacter species were associated with poor growth and increased intestinal inflammation.

Alcohol and Breastfeeding, a review of the issues

Moderate alcohol use by breastfeeding women appears to be relatively common. Alcohol concentrates in breast milk at levels slightly higher than in maternal blood, peaking at 30-60 minutes after consumption. Most studies find no link with the duration of breastfeeding unless drinking is fairly heavy (&gt;2 standard drinks/day). However, seven studies have found that moderate maternal alcohol consumption was associated with a shorter duration of exclusive breastfeeding; one found no difference and one found an increase. Alcohol affects oxytocin release, leading to reductions in breast milk consumption in the following hours. Infant alcohol exposure may increase fussiness and reduce sleep, both temporary if the mother does not continue to drink. These effects on the infant and on the breastfeeding process could be interpreted by mothers as signs of infant dissatisfaction with their breast milk, “insufficient milk,” or other commonly expressed causes for suboptimal breastfeeding patterns. Chronic alcohol consumption, even if moderate, may have a number of more serious effects, including on infant development. In the early weeks or months of life, infant toleration of alcohol is lower than it is at later stages of infancy, and the early breastfeeding process is more susceptible to disruption. Therefore, it may be wise to advise mothers to continue their abstinence from alcohol during pregnancy into the first few months of breastfeeding. Little research has been done on how often women time their drinking so as to avoid infant exposure to alcohol. Health workers and others sometimes propagate myths that alcohol, especially alcoholic beer, is beneficial to breastfeeding. Research is needed in different cultures into whether various forms of cautionary messages are likely to discourage moderate drinkers from initiating breastfeeding or to shorten its duration, and which type of messages if any actually lead to a reduction in drinking during breastfeeding.

Abstract MP63: How Much Does Exclusive Breastfeeding to the Recommended Six Months Increase Maternal Postpartum Weight Loss in Healthy Women?

Objective: Postpartum weight retention increases the risk of future obesity and cardiovascular disease. Although exclusive breastfeeding (EBF) has been promoted as an effective means to lose gestational weight gain, previous studies report mixed findings for the relationship between duration of EBF and maternal postpartum weight loss (PPWL). This study evaluates whether meeting the recommended 6-months of EBF is associated with greater PPWL by 6-months than a shorter duration of EBF. Methods: The Mothers and Infants LinKed for Health (MILK) study is an ongoing prospective cohort of non-diabetic, non-smoking mother-infant dyads, all of whom were exclusively breastfeeding at 1-month postpartum. Breastfeeding exclusivity was subsequently self-reported by mothers at 3 and 6-months postpartum. Maternal pre-pregnancy weight and weight at delivery were abstracted from medical records. PPWL was calculated as maternal weight measured at 1, 3 and 6-months minus maternal weight at delivery. Mixed effects linear regression models were used to test the association of duration of EBF with repeated measures of PPWL after adjustment for covariates including maternal pre-pregnancy weight, gestational weight gain, parity, physical activity and infant sex. Results: Among 315 mothers who were exclusively breastfeeding at 1-month, 93% and 75% continued EBF to 3 and 6-months, respectively. By 6-months postpartum, weight loss (least square means ± standard error) was -8.55 ± 1.31 kg among EBF to 1-month, -10.60 ± 0.82 kg among EBF to 3-months and -11.73 ± 0.37 kg among EBF to 6-months (Figure). EBF to 6-months was associated with greater PPWL by 6-months postpartum than EBF to 1 or 3-months (p&lt;0.05) after covariate adjustment. Conclusion: EBF to 6-months postpartum was associated with greater maternal PPWL than shorter EBF durations. Interventions may promote prolonged EBF as a means of increasing maternal weight loss by 6-months postpartum, but additional research is needed to explore whether these differences persist after weaning.

Breastfeeding assessment in children up to 2 years of age assisted in primary health care of Recife in the state of Pernambuco, Brazil

The scope of this study was to evaluate exclusive and total breastfeeding in children up to 2 years of age treated in Basic Health Units (BHU) of Recife in the state of Pernambuco. A cross-sectional descriptive study was conducted in the Basic Health Units of Mustardinha, Jardim Uchôa, Fernandes Figueira and Upinha Novo Prado. The study population consisted of children of 0 to 24 months of age. One hundred and forty-one children from 0 to 24 months of age were evaluated, of which 56.4% were female, 22% were ≤ 6 months old, 21.3% were between 7 and 12 months of age and 56.7% were between 13 and 24 months of age. Analysis of the prevalence of exclusive and total breastfeeding revealed an average of 60.84 and 182.52 days, respectively. Male children, the use of pacifiers and bottle-feeding was associated with shorter exclusive breastfeeding duration.

Earlier Onset of Maternal Excess Adiposity Associated with Shorter Exclusive Breastfeeding Duration.

Exclusive breastfeeding for 6 months is recommended; however, women with obesity have lower exclusive breastfeeding rates than their normal weight peers. The impact of the timing of maternal excess adiposity onset is unknown. We examined whether the timing of onset of excess weight was related to exclusive breastfeeding duration. Snowball sampling was used for the cross-sectional Breastfeeding Opinions, Outcomes, Behaviors, and Services online survey. The sample was 1,570 mothers who reported their breastfeeding and weight history. Exclusive breastfeeding duration (for first biological child only) was calculated in months and dichotomously (0=< 6 months exclusive breastfeeding; 1=⩾ 6 months exclusive breastfeeding). Participants self-reported their excess weight onset (0=before/during puberty or 1=after puberty). Analysis of covariance results indicated that earlier onset of excess weight was associated with shorter exclusive breastfeeding ( F (1, 1518) = 11.29, p<.001, η2=.01). Those with excess adiposity onset before or during puberty were 1.6 times more likely to experience exclusive breastfeeding failure (< 6 months exclusive breastfeeding) than those with onset after puberty ( OR = 1.57, β = .46, Wald = 11.81, p = .001). Earlier onset of excess adiposity had an adverse influence on exclusive breastfeeding duration. Women with a history of excess adiposity before or during puberty who want to breastfeed may require additional intervention to promote their breastfeeding success.

Association between early-term birth and breastfeeding initiation, duration, and exclusivity: A systematic review.

Infants born early-term, between 37weeks, 0days and 38weeks, 6days of gestation, are more likely to have adverse health outcomes and to undergo interventions that could pose barriers to breastfeeding. The objectives of this review are to examine the effect of early-term birth on breastfeeding initiation and the duration of any and exclusive breastfeeding. We systematically searched PubMed, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), EMBASE, and Scopus, from January 2007 to June 2017, for studies examining the associations between early-term birth and rates of breastfeeding initiation and the duration of any and exclusive breastfeeding. Nine studies were included in the review, of which four assessed breastfeeding initiation rates, eight assessed any breastfeeding duration and two assessed exclusive breastfeeding duration. Two studies found that early-term birth was associated with a lower rate of breastfeeding initiation and five studies reported an association between early-term birth and breastfeeding cessation. One study found that early-term birth was associated with a shorter duration of exclusive breastfeeding. Although the majority of the reviewed studies reported that early-term infants were less likely to be breastfed and were more likely to be breastfed for a shorter duration, study quality varied and the duration of follow-up was short. Further research with longer follow-up would be beneficial to better understand the effect of early-term birth on breastfeeding.

Preditores da introdução de alimentos industrializados na infância: estudo em creches públicas

Exclusive breastfeeding by the sixth month, as well as adequate complementary feeding, are important practices for human development and contribute to the formation of healthy eating habits. In this context, and recognizing the importance of appropriate food practices in the first years of life, the objective of the present study was: to evaluate the age at which processed food was introduced in the diet of 575 children aged 4 to 38 months, attending the nurseries of public child daycare centers in Sao Paulo, and to quantify possible temporal changes and risk factors of premature introduction of these food types. The study was based on two cross-sectional observations, performed in 2007 and 2010, and later Cluster analysis was performed to divide the sample in two groups. A multiple logistic regression analysis was also performed. In the final logistic model, the data collection year (2007), the shorter duration of exclusive breastfeeding, and less maternal education were identified as independent and significant risks to premature introduction of processed food. In view of the results, it is necessary to prepare mothers/ educators to manage infant feeding, reinforcing the benefits of breastfeeding and the disadvantages of the premature introduction of industrialized foods, mainly concerning the mothers’ group with lower education levels.

Pre-gestational excessive weight and duration of breast-feeding.

To investigate whether pre-gestational obesity interferes with the duration of breast-feeding. A cross-sectional study was carried out with a population-based probabilistic sample. The dependent variables were exclusive breast-feeding (EBF) and breast-feeding (BF), as defined by the WHO. The classification of pre-gestational nutritional status was based on the pre-gestational BMI category. A sample of 418 mother-infant pairs from the state of Alagoas, Brazil. The median duration of EBF was 1·9 months (60d), while that of BF was 8·2 months (250d). According to multiple linear regression analysis, the factors that negatively and independently affected the duration of EBF were pre-gestational BMI≥30·0 kg/m2 (-51·9d, 95 % CI -80·4, -23·4), maternal schooling≤9 years (-30·8d, 95 % CI -54·7, -6·9), no prior lactation experience (-29·0d, 95 % CI -45·6, -11·5) and infant pacifier use (-41·4d; 95 % CI 54·5, -28·2). For BF, a higher weaning rate was observed during the first days after birth among children of pre-gestational obese mothers. The results suggest that higher pre-gestational BMI is associated with shorter duration of EBF and BF. Prenatal care provides a privileged opportunity to promote nutritional education, better nutritional status of pregnant woman, and greater success with EBF up to 6 months of age and with longer BF.

Risk factors for exclusive breastfeeding lasting less than two months-Identifying women in need of targeted breastfeeding support.

BackgroundBreastfeeding rates in Sweden are declining, and it is important to identify women at risk for early cessation of exclusive breastfeeding.ObjectiveThe aim of this study was to investigate factors associated with exclusive breastfeeding lasting less than two months postpartum.MethodsA population-based longitudinal study was conducted at Uppsala University Hospital, Sweden. Six hundred and seventy-nine women were included in this sub-study. Questionnaires were sent at five days, six weeks and six months postpartum, including questions on breastfeeding initiation and duration as well as several other background variables. The main outcome measure was exclusive breastfeeding lasting less than two months postpartum. Multivariable logistic regression analysis was used in order to calculate adjusted Odds Ratios (AOR) and 95% Confidence Intervals (95% CI).ResultsSeventy-seven percent of the women reported exclusive breastfeeding at two months postpartum. The following variables in the multivariate regression analysis were independently associated with exclusive breastfeeding lasting less than two months postpartum: being a first time mother (AOR 2.15, 95% CI 1.32–3.49), reporting emotional distress during pregnancy (AOR 2.21, 95% CI 1.35–3.62) and giving birth by cesarean section (AOR 2.63, 95% CI 1.34–5.17).ConclusionsFactors associated with shorter exclusive breastfeeding duration were determined. Identification of women experiencing emotional distress during pregnancy, as well as scrutiny of caregiving routines on cesarean section need to be addressed, in order to give individual targeted breastfeeding support and promote longer breastfeeding duration.