Total Duration Of Breastfeeding Research Articles

Mothers' restrictive eating and food neophobia and fathers' dietary quality are associated with breast-feeding duration and introduction of solid foods: the STEPS study.

The purpose of the present study was to examine the association between parental eating behaviours and dietary patterns and feeding practices of infants and young children. Data on infant-feeding practices were collected from each infant's birth via parentally self-administered follow-up diaries. Three questionnaires, the Three-Factor Eating Questionnaire, the Food Neophobia Scale and the Index of Diet Quality, were administered when the children were aged 4 and 13 months. South-western Finland. Families participating in the STEPS longitudinal cohort study (n 1797). Mean duration of exclusive breast-feeding was 2.4 months and total duration of breast-feeding averaged 8.1 months. The first solid food was introduced into children's diets at the age of 3.9 months, on average. Mothers with highly restrictive eating were more likely to introduce solid foods sooner than mothers who ranked lower in these behaviours (3.8 months v. 4.0 months, P = 0.012). Neophobic mothers breast-fed exclusively (2.0 v. 2.6 months, P = 0.038) and in total (7.2 v. 8.5 months, P = 0.039) for shorter times than average mothers, even after adjusting for various demographic characteristics. Fathers' diet quality was associated with total breast-feeding duration and with introduction of complementary foods in unadjusted analyses and with total breast-feeding duration also after adjusting for confounding factors. Mothers' and fathers' eating patterns and practices are associated with the feeding practices of infants and young children. Health promotion interventions seeking to improve parents' eating patterns might lead to more favourable feeding practices for infants and young children.

Caracterización de la lactancia materna y factores asociados en Puerto Carreño, Colombia

Characterizing breastfeeding in Puerto Carreño and identifying factors associated with providing breast-milk for the newborn, exclusive breastfeeding and total breastfeeding. This descriptive, cross-sectional study, using structured individual and non-random surveys, involved 609 mothers. The statistical analysis methods included univariate and bivariate analysis, survival curves, binary logistic regression and Cox proportional hazard models. The duration of total and exclusive breastfeeding was higher than reported times at national and regional level in most cases. The main factors associated with breastfeeding were related to occupation, family background, Indigenous status, previous maternal experience and access to healthcare services. Exclusive breastfeeding was influenced more by the mother'’s occupation, while the total duration of breastfeeding was influenced by home-based family support network. The results are significant regarding planning intervention measures addressed towards improving breastfeeding habits in the target municipality.

209: Total Breastfeeding Duration and Dental Cavities in Early Childhood

209: Total Breastfeeding Duration and Dental Cavities in Early Childhood

Initiation of Complementary Feeding and Duration of Total Breastfeeding: Unlimited Access to Lactation Consultants Versus Routine Care at the Well-Baby Clinics

Breastfeeding has several advantages for both mother and child. Lactation consultants may promote prolonged breastfeeding, but little is known about their impact on the initiation of complementary feeding. Dietary intake during the initial complementary feeding period from 5 to 6 months was collected on mother-infant pairs who had unlimited access to lactation consultants along with those mother-infant pairs who received routine care at the well-baby clinics. The total duration of breastfeeding in each study population was also recorded, and total breastfeeding durations of infants receiving complementary foods from 4 months and those exclusively breastfed for 6 months in each of the two study populations were compared. Higher proportion of infants of mothers with unlimited access to lactation consultants were fed vegetable and vegetable purées (p=0.05) and more than one food type (p=0.05) at 5 months. Furthermore, a lower percentage of them had three meals per day at 6 months (p=0.001) compared with those receiving routine care at the well-baby clinics. Infants exclusively breastfed for 6 months all had similar duration of total breastfeeding. Mother-infant pairs with unlimited access to lactation consultant had slower introduction of complementary foods at the initial complementary feeding period, according to number of infant's meals at 6 months of age. Furthermore, those exclusively breastfed for 6 months had more prolonged breastfeeding compared with mothers who began complementary feeding at 4 months regardless of exposure to lactation consultants.

Breast‐Feeding and Weaning Practices in the DONALD Study

Besides influencing short- and long-term health status, infant feeding practices are known to have an effect on later food preferences. This study aimed to identify present trends in breast-feeding duration and weaning practices with special focus on preparation methods of complementary food (CF), that is, homemade and commercial CF. In total, 1419 three-day weighed diet records collected between 2004 and 2012 from 366 children of the German DOrtmund Nutritional and Anthropometric Longitudinally Designed study ages 6 to 24 months were analysed. Full (n = 339) and total breast-feeding duration (n = 344) was collected by questionnaire. To investigate age and time trends, logistic regression and polynomial mixed regression models were used. Infants born between 2008 and 2012 were 3.3-fold less likely to be fully breast-fed for ≥4 months than those born before 2004 (P < 0.0001). Overall, 59.3% commercial, 21.1% homemade, and 19.6% combined CF was consumed by the study sample. Subjects with high commercial CF consumption (percentage of commercial CF > median 62%) were significantly older (P < 0.0001), showed shorter full and total breast-feeding duration (P < 0.0001), and were more likely to have mothers with a lower educational status (P = 0.01). Both commercial and homemade CF showed opposing, nonlinear age trends. No time trends could be found. Decreasing duration of full breast-feeding should encourage health care providers to further promote longer breast-feeding duration. With the constantly high consumption of commercial CF at all ages, nutritional adequacy of both homemade and commercial CF needs to be investigated closer, as does their long-term influence on health and dietary habits, for example, fruit and vegetable intake.

Maternal overweight impacts infant feeding patterns—the STEPS Study

We examined how maternal overweight impacts full breastfeeding (BF), total duration of BF and the age of introduction of complementary foods (CFs) and whether these have effect on children's growth from 0 to 2 years. From 1797 families participating in the STEPS Study, 848 children had data on BF and anthropometric data at 13 months and 2 years of age and were included in this study. Data on BF and CFs were collected using a self-administered follow-up diary. Information regarding maternal weight, height, pregnancy and delivery were received from maternity clinics and the National Longitudinal Census Files. The children's weight and length/height were recorded during the study visits at 13 months and 2 years. Overweight women breastfed fully (2.2 vs 2.8 months, P<0.0001) and totally (7.4 vs 9.0 months, P<0.0001) for a shorter time and introduced CFs earlier (4.1 vs 4.3 months, P=0.02) than normal weight women. Children of overweight women were heavier and had a higher body mass index at 2 years than children of normal weight women. At 2 years of age 30% of boys and 17% of girls were overweight or obese. However, children's obesity risk was not increased by maternal overweight (odds ratio (OR) 1.04, P=0.12). Longer duration of full BF (OR 0.86, P=0.04) and partial BF (OR 0.91, P=0.02) and delayed introduction of CFs (OR 0.69, P=0.03) were protective against obesity. Our study suggests that women who were overweight or obese before pregnancy breastfed for a shorter time and introduced CFs earlier than normal weight women, which may further impact children's growth.

Breastfeeding and the maternal risk of type 2 diabetes: A systematic review and dose–response meta-analysis of cohort studies

Background and aimsBreastfeeding has been associated with reduced risk of maternal type 2 diabetes in some cohort studies, but the evidence from published studies have differed with regard to the strength of the association. To clarify this association we conducted a systematic review and dose–response meta-analysis of breastfeeding and maternal risk of type 2 diabetes. Methods and resultsWe conducted a systematic review and dose–response meta-analysis of prospective studies of breastfeeding and maternal risk of type 2 diabetes. We searched the PubMed, Embase and Ovid databases up to September 19th 2013. Summary relative risks were estimated using a random effects model. Six cohort studies including 10,842 cases among 273,961 participants were included in the meta-analysis. The summary RR for the highest duration of breastfeeding vs. the lowest was 0.68 (95% CI: 0.57–0.82, I2 = 75%, pheterogeneity = 0.001, n = 6). The summary RR for a three month increase in the duration of breastfeeding per child was 0.89 (95% CI: 0.77–1.04, I2 = 93%, pheterogeneity < 0.0001, n = 3) and the summary RR for a one year increase in the total duration of breastfeeding was 0.91 (95% CI: 0.86–0.96, I2 = 81%, pheterogeneity = 0.001, n = 4). There was little difference in the summary estimates whether or not BMI had been adjusted for. The inverse associations appeared to be nonlinear, pnonlinearity < 0.0001 for both analyses, and in both analyses the reduction in risk was steeper when increasing breastfeeding from low levels. ConclusionThis meta-analysis suggests that there is a statistically significant inverse association between breastfeeding and maternal risk of type 2 diabetes.

Abstract B115: Excessive milk production during breast feeding prior to breast cancer diagnosis is associated with increased risk for early events

Abstract Background: Breast feeding is a known protective factor against breast cancer. Breast feeding duration is influenced by hormone levels, milk production, and lifestyle factors. We aimed to investigate how breast feeding duration and milk production affect tumor characteristics and risk for early breast cancer events in women who subsequently developed breast cancer. Methods: Between 2002 and 2008, 634 primary breast cancer patients in Lund, Sweden, took part in an ongoing prospective cohort study. Data were extracted from preoperative questionnaires, pathology reports, patients' charts and Swedish registries from 592 patients without preoperative treatment. Results: Breast feeding duration ≥12 months of the first child was associated with higher frequency of ER+/PgR+ tumors (P=0.02). Median follow-up time was 4.9 years. Higher risk for early events was observed for breast feeding duration of first child &amp;gt;12 months (LogRank P=0.001), total breast feeding duration &amp;gt;12 months (LogRank P=0.004), as well as ‘excessive milk production’ during breast feeding of the first child (LogRank P=0.003). Patients with ‘almost no milk production’ had no events. In a multivariable model including both ‘excessive milk production’ and breast feeding duration of the first child &amp;gt;12 months, both were significantly associated with a two-fold risk for early events, adjusted HRs 2.19 (95% CI: 1.17-4.11) and 2.61 (1.06-6.38), respectively, adjusted for age, invasive tumor size, axillary lymph node involvement, ER and PgR status, age at first birth, time since last birth, smoking status, and BMI, while total breast feeding duration was not. ‘Excessive milk production’ was associated with a two-fold risk of early distant metastases, adjusted HR 2.41 (1.09-5.32), but not breast feeding duration. Conclusion: ‘Excessive milk production’ during breast feeding was associated with higher risk for early events independent of tumor characteristics, while patients who reported ‘almost no milk production’ had no events. This finding stresses the need to consider host factors in the evaluation of prognostic markers. Citation Format: Emma Gustbée, Charlotte Anesten, Andrea Markkula, Maria Simonsson, Carsten Rose, Christian Ingvar, Helena Jernstrom. Excessive milk production during breast feeding prior to breast cancer diagnosis is associated with increased risk for early events. [abstract]. In: Proceedings of the AACR Special Conference on Advances in Breast Cancer Research: Genetics, Biology, and Clinical Applications; Oct 3-6, 2013; San Diego, CA. Philadelphia (PA): AACR; Mol Cancer Res 2013;11(10 Suppl):Abstract nr B115.

Infant feeding and school attainment in five cohorts from low- and middle-income countries.

BackgroundPerformance in intelligence tests tends to be higher among individuals breastfed as infants, but little is known about the association between breastfeeding and achieved schooling. We assessed the association of infant feeding with school achievement in five cohorts from low- and middle-income countries. Unlike high-income country settings where most previous studies come from, breastfeeding is not positively associated with socioeconomic position in our cohorts, thus reducing the likelihood of a spurious positive association.Methodology and Principal FindingsParticipants included 10,082 young adults from five birth cohorts (Brazil, India, Guatemala, the Philippines, and South Africa). The exposures variables were whether the subject was ever breastfed, total duration of breastfeeding, and age at introduction of complementary foods. We adjusted the estimates for age at follow up, sex, maternal age, smoking during pregnancy, birthweight and socioeconomic position at birth. The key outcome was the highest grade achieved at school. In unadjusted analyses, the association between ever breastfeeding and schooling was positive in Brazil, inverse in the Philippines, and null in South Africa; in adjusted analyses, these associations were attenuated. In Brazil, schooling was highest among individuals breastfed for 3–12 months whereas in the Philippines duration of breastfeeding was inversely associated with schooling; and null associations were observed in South Africa and Guatemala. These associations were attenuated in adjusted models. Late introduction of solid foods was associated with lower schooling achievement in Brazil and South Africa.ConclusionMeasures of breastfeeding are not consistently related to schooling achievement in contemporary cohorts of young adults in lower and middle-income countries.

Medicine use and safety while breastfeeding: investigating the perspectives of community pharmacists in Australia

Consumers and health professionals rely on community pharmacists for accurate information about the safety of medicines. Many breastfeeding women require medications, yet we know little about the advice provided to them by pharmacists in Australia. The aim of this study therefore was to investigate the perspectives of community pharmacists in Australia on medication use and safety in breastfeeding using a postal survey of a national random sample of 1166 community pharmacies in 2011. One hundred and seventy-six pharmacists responded (51% female). Of the 52% of participants with children, many (70%) had a total breastfeeding duration (self or partner) of 27 weeks or more. The majority (92%) were confident about supplying or counselling on medication during breastfeeding. The most commonly used resources were drug company information, Australian Medicines Handbook and the Royal Women's Pregnancy and Breastfeeding Medicine Guide. Most (80%) believed the available information to be adequate and 86% thought it accessible. Over one-third were unaware that ibuprofen and metronidazole are compatible with breastfeeding. Most (80%) were able to name at least one medicine that may decrease milk supply. We found that community pharmacists discuss medicine use in lactation and are confident of their ability to do so; however, their knowledge may be variable.

Excessive milk production during breast-feeding prior to breast cancer diagnosis is associated with increased risk for early events

Breast-feeding is a known protective factor against breast cancer. Breast-feeding duration is influenced by hormone levels, milk production, and lifestyle factors. The aims were to investigate how breast-feeding duration and milk production affected tumor characteristics and risk for early breast cancer events in primary breast cancer patients. Between 2002 and 2008, 634 breast cancer patients in Lund, Sweden, took part in an ongoing prospective cohort study. Data were extracted from questionnaires, pathology reports, and patients’ charts from 592 patients without preoperative treatment. Breast-feeding duration ≤12 months of the first child was associated with higher frequency of ER+/PgR+ tumors (P=0.02). Median follow-up time was 4.9 years. Higher risk for early events was observed for breast-feeding duration of first child >12 months (LogRank P=0.001), total breast-feeding duration >12 months (LogRank P=0.008), as well as ‘excessive milk production’ during breast-feeding of the first child (LogRank P=0.001). Patients with ‘almost no milk production’ had no events. In a multivariable model including both ‘excessive milk production’ and breast-feeding duration of the first child >12 months, both were associated with a two-fold risk for early events, adjusted HRs 2.33 (95% CI: 1.25-4.36) and 2.39 (0.97-5.85), respectively, while total breast-feeding duration was not. ‘Excessive milk production’ was associated with a two-fold risk of early distant metastases, adjusted HR 2.59 (1.13-5.94), but not duration. In conclusion, ‘excessive milk production’ during breast-feeding was associated with higher risk for early events independent of tumor characteristics, stressing the need to consider host factors in the evaluation of prognostic markers.Electronic supplementary materialThe online version of this article (doi:10.1186/2193-1801-2-298) contains supplementary material, which is available to authorized users.

Factors influencing breastfeeding duration: a survey in a Turkish population

Breastfeeding provides perfect nutrition for infants and is a source of many health benefits for both mother and baby. To obtain the maximum beneficial effects of breast milk, it is necessary to prolong the breastfeeding duration. In this study, we investigated the factors influencing the duration of breastfeeding. We conducted a 32-question survey of mothers with children aged 2-4 years, who presented to our medical school's pediatric outpatient clinics. The questionnaire solicited information on demographics and breastfeeding attitudes. We found correlations between total duration of breastfeeding and the time the mother and baby spent together (sharing a room to sleep at night) and the father's engagement in breastfeeding. Breastfeeding duration inversely correlated with maternal employment. Total duration of breastfeeding did not correlate with breastfeeding education by health personnel, the mother's education level, the gender of the child, regular prenatal care visits, the use of a pacifier, the interval between birth and the onset of breastfeeding, gestational age, method of delivery, or the birth weight of the infant. Our findings suggest several strategies to increase the duration of breastfeeding, including educating fathers along with mothers, supporting a shared bedroom until the child is 2 years of age, and promoting measures that allow mothers to be with their children during working hours.

Association Between Total Duration of Breastfeeding and Iron Deficiency

To determine whether there is an association between the total breastfeeding duration and iron stores, iron deficiency, and iron deficiency anemia in healthy urban children. A cross-sectional study of healthy children, aged 1 to 6 years, seen for primary health care between December 2008 and July 2011 was conducted through the TARGet Kids! practice-based research network. Univariate and adjusted regression analyses were used to evaluate an association between total breastfeeding duration and serum ferritin, iron deficiency, and iron deficiency anemia. Included were 1647 healthy children (median age 36 months) with survey, anthropometric, and laboratory data. An association was found between increasing duration of breastfeeding and lower serum ferritin (P = .0015). Adjusted logistic regression analysis revealed the odds of iron deficiency increased by 4.8% (95% confidence interval: 2%-8%) for each additional month of breastfeeding. Exploratory analysis suggested an increasing cumulative probability of iron deficiency with longer total breastfeeding duration with an adjusted odds ratio of 1.71 (95% confidence interval: 1.05-2.79) for iron deficiency in children breastfed over versus under 12 months of age. The relationship between total breastfeeding duration and iron deficiency anemia did not meet statistical significance. Increased total breastfeeding duration is associated with decreased iron stores, a clinically important association warranting additional investigation.

Association Between Total Duration of Breastfeeding and Iron Deficiency

Association Between Total Duration of Breastfeeding and Iron Deficiency

Improving health of children in urban slums through an integrated model based approach — a case study from Chennai

An integrated model based approach was used to improve health status of children in an urban slum. An urban slum was selected based on fixed criteria and health needs were assessed. The environmental conditions were improved. Health care needs were taken care of and self-help groups were started to make them financially independent. This model was evaluated in 204 families with 350 under-five children. Survey revealed that 88% of them used safe garbage disposal and 95% of them had household latrines. Only 24% of under-five children had water borne morbidity in past one year and there were no vector borne diseases. 71% of the eligible couples followed some contraception. Mean duration of exclusive breast feeding was 7 months and average total duration of breast feeding was 15 months. Integrated model based approach based on principles of primary health care works in urban slum with effective community participation.

Breastfeeding and the risk of breast cancer in BRCA1 and BRCA2 mutation carriers

IntroductionBreastfeeding has been inversely related to breast cancer risk in the general population. Clarifying the role of breastfeeding among women with a BRCA1 or BRCA2 mutation may be helpful for risk assessment and for recommendations regarding prevention. We present an updated analysis of breastfeeding and risk of breast cancer using a large matched sample of BRCA mutation carriers.MethodsWe conducted a case-control study of 1,665 pairs of women with a deleterious mutation in either BRCA1 (n = 1,243 pairs) or BRCA2 (n = 422 pairs). Breast cancer cases and unaffected controls were matched on year of birth, mutation status, country of residence and parity. Information about reproductive factors, including breastfeeding for each live birth, was collected from a routinely administered questionnaire. Conditional logistic regression was used to estimate the association between ever having breastfed, as well as total duration of breastfeeding, and the risk of breast cancer.ResultsAmong BRCA1 mutation carriers, breastfeeding for at least one year was associated with a 32% reduction in risk (OR = 0.68; 95% CI 0.52 to 0.91; P = 0.008); breastfeeding for two or more years conferred a greater reduction in risk (OR = 0.51; 95% CI 0.35 to 0.74). Among BRCA2 mutation carriers, there was no significant association between breastfeeding for at least one year and breast cancer risk (OR = 0.83; 95% CI 0.53 to 1.31; P = 0.43).ConclusionsThese data extend our previous findings that breastfeeding protects against BRCA1-, but not BRCA2-associated breast cancer. BRCA mutation carriers should be advised of the benefit of breastfeeding in terms of reducing breast cancer risk.

Breast feeding practices among health care professionals in a tertiary care hospital from South India

Personal breastfeeding experiences of health care professionals play a major role in influencing their attitudes and expertise regarding counseling and managing breastfeeding issues in patients. This study was done with an objective of studying the current breastfeeding practices among health care professionals (HP) and their spouses and the factors influencing them. All children < 5 years of age, residing in hospital's residential quarters, were included. A detailed breastfeeding history demographic data were obtained following a semi-structured interview with mothers. Among 81 children included for analysis, in 73 children (90.1%), an initiation of breastfeeding was within 24 hours of birth and in 36 children (44.4%), it was within first hour of life. 43 children (58.1%) were exclusively breast fed for 6 months. Mean duration of EBF was 5.3 months and total duration of breastfeeding was 13.2 months. Gender of HP, gender of the child and socio-economic factors were not found to significantly affect breastfeeding practices among HP.

Effect of rearing environment on the feeding pattern of under two years old Nigerian children

With economic pressures on families increasing, more women are working outside the home leaving their children in day care centres. In a community-based, descriptive cross-sectional study, the feeding pattern in two groups of children under two years old, cared for in two different rearing environments: home environment and day care centres, was compared, and the effect of rearing environment on their feeding pattern was assessed. Two groups of children from lower-middle socio-economic backgrounds were recruited into the study. Using simple random sampling, 250 under two years old children attending day care centres in a medium-high density area of Osogbo metropolis and 250 under two years old children cared for in the home environment in the same area were enrolled in the study. Information was collected by use of a pre-tested and structured questionnaire administered to the parents of the children, the proprietors and the attendants of the day care centres. The feeding pattern of the children in both groups revealed a low level of breast-feeding practices, early initiation of complementary feeding and short total duration of breast-feeding. The study also showed that putting children in day care centres may militate against the mother being able to practise exclusive breast-feeding and may also affect total duration of breast-feeding. The study concluded that rearing environment has an effect on the feeding patterns of children. Health education of both mothers and health professionals and provision of crèches or day care centres by companies, institutions, hospitals and schools in their premises are recommendations for improving the situation.

Progestin-only contraception prevents bone loss in postpartum breastfeeding women

BackgroundThere are an increase in bone loss during the first 6 months postpartum and a complete recovery postweaning. A few studies of steroid contraceptive use during this period provide some evidence towards protection of bone loss with progestin-only contraceptive methods. ObjectiveThe study was conducted to evaluate forearm bone mineral density (BMD) of breastfeeding postpartum women using nonhormonal and progestin-only contraceptive methods. Study DesignA prospective cohort study of postpartum women had an analysis performed at 6 months postpartum correlating BMD with contraceptive use. Forearm BMD was measured 7–10 days, 3 months and 6 months postpartum. Eighty-two women were analyzed, comparing nonhormonal (54) and progestin-only (28) contraceptive methods. Information about breastfeeding duration, amenorrhea and body mass index was collected. ResultsBaseline characteristics of the study population showed no statistical differences between the groups. The median duration of breastfeeding for both groups was 183 days. A significant BMD decrease was observed for the nonhormonal group (p<.001); however, no statistical difference was detected for the progestin-only group. Body mass index, BMD at 7–10 days postpartum and total duration of breastfeeding were positively correlated with BMD at 6 months. ConclusionsOur findings suggest a preventive effect towards postpartum bone loss with progestin-only contraception in breastfeeding women.

Nutritional Status of Preschool (2-6 Years of Age) Children

Early childhood is a critical life period because of its importance for supplying regular and adequate nutrition, and giving essential nutritional education to the children. In the present study, between January 2004 and March 2006, food consumption of 2- to 6-year-old children from different socioeconomic levels in Izmir was investigated. Anthropometric measurements of these 518 children were also recorded. SPSS 14.0 for Windows was used for statistical analysis. Total duration of breastfeeding of the subjects was 11.4±7.0 months, and the duration for exclusively breastfeeding was 4.55±1.8 months. The frequency of children with height SDS value of less than -2 SD was 3.4 %, and those with a weight for height SDS value higher than +2 SD was 8.3 %. Out of the daily energy requirements, 48.8 % was provided from carbohydrate, 14.6 % from protein, and 36.5 % from fat. The children from low socioeconomic levels consumed more carbohydrate, and less protein and fat. Daily water, fiber, fluoride, potassium, linoleic acid and vitamin D intake of children was low, while daily energy, iron and folic acid intake was just under the recommended level. The carbohydrate, protein, fat and energy intake was highest at the evening meal. Because poverty has a negative effect on the health of children, nutritional support is needed to the children of poor societies.