Association of Maternal Confidence and Breastfeeding Practices in Hispanic Women Compared to Non-Hispanic White Women

Understanding modifiable factors related to breastfeeding initiation and duration is critical to increase breastfeeding rates. Maternal parenting confidence is a modifiable factor whose association with breastfeeding duration has not previously been investigated. In a retrospective cohort of 1023 mother-infant dyads, the association between maternal confidence and breastmilk feeding at 6 and 12 months of age were analyzed. The association of breastmilk frequency categories and maternal confidence score at 6 and 12 months was examined using multinomial logistic regression stratified by race, ethnicity, and adjusted for gestational age. We found that breastmilk feeding frequency at 6 months was negatively associated with the maternal confidence score. After stratification by ethnicity, the association was no longer significant. There was no association between human milk feeding frequency at 12 months and maternal confidence score at 12 months. Our results demonstrate the need for additional research to identify modifiable factors to increase breastfeeding rates.

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Breastfeeding rates and duration in Germany: a Bavarian cohort study

British Journal Of Nutrition ◽

10.1017/s0007114508864835 ◽

2008 ◽

Vol 99 (5) ◽

pp. 1127-1132 ◽

Cited By ~ 72

Author(s):

Martina Kohlhuber ◽

Barbara Rebhan ◽

Ursula Schwegler ◽

Berthold Koletzko ◽

Hermann Fromme

Keyword(s):

Cohort Study ◽

Influencing Factor ◽

Negative Attitude ◽

Breastfeeding Duration ◽

Breastfeeding Initiation ◽

Breastfeeding Promotion ◽

Breastfeeding Rate ◽

Lower Education ◽

Breastfeeding Rates ◽

Breastfeeding Problems

Breastfeeding is the recommended feeding for all healthy infants. The aim of our study was to assess the current state of breastfeeding prevalence, duration and behaviour in Bavaria, Germany as a basis for targeting breastfeeding promotion measures. The Bavarian Breastfeeding Study is a prospective cohort study of 3822 mothers who delivered in April 2005 in Bavaria, Germany. Breastfeeding duration and determinants such as socioeconomic status, attitudes towards breastfeeding, birth mode and breastfeeding problems were assessed by questionnaires 2–6 d after birth and 2, 4, 6, and 9 months after birth. The initial breastfeeding rate was 90 %. After 4 months 61 % still breastfed (any breastfeeding). In the multivariate analyses the main influencing factor reducing breastfeeding initiation was the partner's negative attitude towards breastfeeding (OR 21·79; 95 % CI 13·46, 35·27). No initial breastfeeding was also associated with lower education, maternal grandmother's negative attitude and pre-term birth. Protective factors were primary breastfeeding experience and information on breastfeeding before birth. Breastfeeding duration < 4 months was strongly associated with breastfeeding problems (OR 7·56; 95 % CI 6·21, 9·19), smoking, lower education, partner's negative attitude and Caesarean section. Since the attitude of family members is an important influencing factor on breastfeeding rates, breastfeeding promotion should also target the partners of pregnant women and the families of newborn infants. Public health interventions such as more effective support for the management of breastfeeding problems, especially in lower social status families, should be implemented and their effectiveness should be critically evaluated.

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Racial and Ethnic Differences in Breastfeeding

10.1542/9781610022873-racial ◽

2018 ◽

pp. 74-84

Author(s):

Chelsea O. McKinney ◽

Jennifer Hahn-Holbrook ◽

P. Lindsay Chase-Lansdale ◽

Sharon L. Ramey ◽

Julie Krohn ◽

...

Keyword(s):

Family History ◽

Demographic Characteristics ◽

Breastfeeding Duration ◽

Breastfeeding Initiation ◽

Black Mothers ◽

Hispanic Mothers ◽

White Mothers ◽

History Of ◽

Breastfeeding Rates ◽

Racial Ethnic

OBJECTIVES Breastfeeding rates differ among racial/ethnic groups in the United States. Our aim was to test whether racial/ethnic disparities in demographic characteristics, hospital use of infant formula, and family history of breastfeeding mediated racial/ethnic gaps in breastfeeding outcomes. METHODS We analyzed data from the Community and Child Health Network study (N = 1636). Breastfeeding initiation, postnatal intent to breastfeed, and breastfeeding duration were assessed postpartum. Hierarchical linear modeling was used to estimate relative odds of breastfeeding initiation, postnatal intent, and duration among racial/ethnic groups and to test the candidate mediators of maternal age, income, household composition, employment, marital status, postpartum depression, preterm birth, smoking, belief that “breast is best, ” family history of breastfeeding, in-hospital formula introduction, and WIC participation. RESULTS Spanish-speaking Hispanic mothers were most likely to initiate (91%), intend (92%), and maintain (mean duration, 17.1 weeks) breastfeeding, followed by English-speaking Hispanic mothers (initiation 90%, intent 88%; mean duration, 10.4 weeks) and white mothers (initiation 78%, intent 77%; mean duration, 16.5 weeks); black mothers were least likely to initiate (61%), intend (57%), and maintain breastfeeding (mean duration, 6.4 weeks). Demographic variables fully mediated disparities between black and white mothers in intent and initiation, whereas demographic characteristics and in-hospital formula feeding fully mediated breastfeeding duration. Family breastfeeding history and demographic characteristics helped explain the higher breastfeeding rates of Hispanic mothers relative to white and black mothers. CONCLUSIONS Hospitals and policy makers should limit in-hospital formula feeding and consider family history of breastfeeding and demographic characteristics to reduce racial/ethnic breastfeeding disparities.

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Gestational Diabetes and Breastfeeding Outcomes: A Systematic Review

Asia Pacific Journal of Public Health ◽

10.1177/1010539519833497 ◽

2019 ◽

Vol 31 (3) ◽

pp. 183-198 ◽

Cited By ~ 3

Author(s):

Phung Thi Hoang Nguyen ◽

Ngoc Minh Pham ◽

Khac Tan Chu ◽

Dat Van Duong ◽

Dung Van Do

Keyword(s):

Diabetes Mellitus ◽

Systematic Review ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

Web Of Science ◽

Breastfeeding Duration ◽

Breastfeeding Initiation ◽

Apparent Difference ◽

Inclusion Criteria ◽

Breastfeeding Rates

Studies of gestational diabetes mellitus in relation to breastfeeding are limited, while their findings are inconsistent. This systematic review was conducted to assess the associations between gestational diabetes and breastfeeding outcomes. An initial search of PubMed, Web of Science, and ProQuest identified 518 studies, and after applying the inclusion criteria, 16 studies were finally included in the review. Four studies reported that “exclusive/predominant/full breastfeeding” rates at discharge were lower in mothers with gestational diabetes than in those without gestational diabetes, and 2 studies showed a shorter duration of “exclusive/predominant breastfeeding” in the former than in the latter. However, most studies found no apparent difference in the rate of “breastfeeding initiation”, “any breastfeeding” duration, or “any breastfeeding” in hospital and at discharge between mothers with and without gestational diabetes. In summary, mothers with gestational diabetes were less likely to exclusively breastfeed their infants and may have a shorter breastfeeding duration than other mothers.

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Trends in breastfeeding practices and mothers’ experience in the French NutriNet-Santé cohort

International Breastfeeding Journal ◽

10.1186/s13006-021-00397-x ◽

2021 ◽

Vol 16 (1) ◽

Author(s):

Frédéric Courtois ◽

Sandrine Péneau ◽

Benoît Salanave ◽

Valentina A. Andreeva ◽

Marie Françoise Roland-Cachera ◽

...

Keyword(s):

Public Health ◽

Census Data ◽

Breastfeeding Duration ◽

Breastfeeding Initiation ◽

Breastfeeding Support ◽

The Public ◽

The Past ◽

Breastfeeding Practices ◽

Breastfeeding Education ◽

Breastfeeding Cessation

Abstract Background France has one of the lowest rates in the world regarding breastfeeding initiation and duration. Few studies have explored breastfeeding practices in France since the middle of the twentieth century, or following from initiation to cessation. The purpose of our study was to determine trends in breastfeeding over the past decades regarding public health recommendations, and to examine mothers’ perceptions about factors known to have an impact on breastfeeding support and cessation. Methods From the NutriNet-Santé cohort, 29,953 parous women (launched in 2009 to study relation between nutrition and health), were included in the present study. Using web-questionnaires, they were asked retrospectively if they had breastfed their youngest child or not, and if so, the duration of exclusive and total breastfeeding. For those who had breastfed, we investigated their perceptions about support at initiation and during the entire breastfeeding period and reasons for breastfeeding cessation. We also asked those who did not breastfeed about their perceptions and reasons for infant formula feeding their youngest child. Analyses were weighted according to the French census data. Results In the NutriNet-Santé cohort, 67.3% of mothers breastfed their youngest child. The proportion of breastfed children increased over the past few decades, from 55.0% (95% CI 54.3, 55.6) in the 1970s to 82.9% (82.4, 83.4) in the 2010s. Total and exclusive breastfeeding duration went from 3.3 months and 2.4 months respectively in the 1970s to 5.9 months and 3.2 months respectively in the 2010s. Most mothers felt supported at initiation and during the breastfeeding period. A reported desire to have breastfed longer than two months was 59.5%. Mothers who did not breastfeed did it by choice (64.3%). They did not feel guilty (78.2%) and did not perceive a problem not to breastfeed (58.8%), but almost half of them would have liked to have breastfed (45.9%). Conclusion Breastfeeding duration has increased in the past decades but did not reach the public health recommendations threshold. Targets other than mothers have to be considered for breastfeeding education, like the partner and her environment, to increase breastfeeding practices. Trial registration The study was registered at ClinicalTrials.gov (NCT03335644).

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Maternal Education, Breastfeeding Behaviours and Lactational Amenorrhoea: Studies Among Two Ethnic Communities in Ile Ife, Nigeria

Nutrition and Health ◽

10.1177/026010609601100204 ◽

1996 ◽

Vol 11 (2) ◽

pp. 115-126 ◽

Cited By ~ 13

Author(s):

Anita A. Davies-Adetugbo ◽

E.O. Ojofeitimi

Keyword(s):

Formal Education ◽

Maternal Education ◽

Child Survival ◽

Important Variable ◽

Breastfeeding Duration ◽

Breastfeeding Initiation ◽

Southwestern Nigeria ◽

Average Decrease ◽

Lactating Mothers ◽

Milk Substitutes

Breastfeeding is an important child survival strategy. This report aims to describe the unique contributions of education, ethnicity, and other variables to breastfeeding outcomes. The study was conducted among two groups of lactating mothers in Ile Ife, southwestern Nigeria, using structured questionnaires focusing on their breastfeeding history and current practice. Breastfeeding initiation was delayed in both groups, and primary education is the most significant predictor of initiation of breastfeeding within 6 hours of delivery (OR = 3.92, p = 0.0117). Breastfeeding duration (SD) was 13.7 (4.3) months for the Yorubas and 17.5 (3.4) for the Hausas. Its only significant predictors are education (p < = 0.0001), with an average decrease in breastfeeding duration of 3.2 and 6.6 months with mother's education to the primary and post-primary levels respectively, compared with mothers with no education. In turn, breastfeeding duration is the most significant predictor of the duration of lactational amenorrhoea (p = 0.0000). Mothers with some formal education are also more likely to start feeding human milk substitutes at 2 weeks (OR = 3.83, p = 0.024). The most important variable determining breastfeeding in this study is education. The educated mother is more likely to be involved in economic activity away from the home. To protect breastfeeding in these communities, there is a need for programmes to support the breastfeeding mother who works.

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Trends in modifiable behaviorally related cancers: Who is affected the most?

Journal of Clinical Oncology ◽

10.1200/jco.2021.39.15_suppl.e13531 ◽

2021 ◽

Vol 39 (15_suppl) ◽

pp. e13531-e13531

Author(s):

John Chan ◽

Michelle Ann P. Caesar ◽

Chloe Chan ◽

Michael Richardson ◽

Daniel Stuart Kapp ◽

...

Keyword(s):

Breast Cancer ◽

United States ◽

Physical Inactivity ◽

White Women ◽

Postmenopausal Breast Cancer ◽

The United States ◽

Racial Groups ◽

Factors Associated ◽

Modifiable Factors ◽

Asian Men

e13531 Background: To examine trends in modifiable behaviorally related cancers among racial groups in the United States. Methods: Data were obtained from the United States Cancer Statistics (USCS) database for all cancers diagnosed between 2001 and 2017. Alcohol-associated cancers, HPV-associated, obesity-associated, physical inactivity-associated, and tobacco-associated were defined using ICD-O-3 site codes. SEER*Stat 8.3.8 and Joinpoint regression program 4.8.0.1 were used to calculate the trends of associated cancers expressed per 100,000. Results: In women, the incidence of all cancers has decreased significantly or remain unchanged for all racial groups in 2017, with the exception of an increase of HPV related cancers in white women (APC = 0.77%, p < 0.001), obesity related cancers in Hispanic women (APC = 0.46%, p < 0.001), and postmenopausal breast cancer in Black and Asian women (APC 0.78%, 1.06%, p < 0.001). The incidence of alcohol, tobacco, obesity, and physical inactivity associated cancer decreased significantly in men for all racial groups in 2017. HPV related cancers increased annually by 3.13% (p < 0.001) in White men and 0.90% in Asian men (p = 0.022). The highest decrease in modifiable factors associated with cancers was in physical inactivity related cancers in black men from the west (APC = -3.79, p < 0.001). The intersection of black race and U.S. region had the highest decreases in all cancers except obesity-related cancers where the intersection of Asian race and Midwest region had the highest decrease. Conclusions: In women, most modifiable factors associated with cancer are decreasing except in obesity related cancers and physical inactivity/obesity related postmenopausal breast cancer. In men, these rates of cancer are decreasing for all racial groups except HPV related cancers in White and Asian men.

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Prepregnancy Depression and Breastfeeding Duration: A Look at Maternal Age

Journal of Pregnancy ◽

10.1155/2018/4825727 ◽

2018 ◽

Vol 2018 ◽

pp. 1-7 ◽

Cited By ~ 3

Author(s):

Jordyn T. Wallenborn ◽

Anny-Claude Joseph ◽

Whitney C. Graves ◽

Saba W. Masho

Keyword(s):

Mental Health ◽

Maternal Age ◽

Multinomial Logistic Regression ◽

Age Groups ◽

The United States ◽

Poor Mental Health ◽

Breastfeeding Duration ◽

Pregnancy Risk ◽

Care Models ◽

History Of

Background. In the United States, major depressive disorder affects one in five women aged 20-40 years. During these childbearing years, depression can negatively impact maternal behaviors that are crucial for infant growth and development. This study examined the relationship between prepregnancy depression and breastfeeding duration by maternal age. Methods. Data from Phase 7 (2012-2013) of the Pregnancy Risk Assessment Monitoring System (N=62,483) were analyzed. Prepregnancy depression was dichotomized while breastfeeding duration was categorized as never breastfed, breastfed 8 weeks or less, and breastfed more than 8 weeks. Maternal age was a significant effect modifier; therefore, results were stratified by maternal age. Multinomial logistic regression was used to obtain odds ratios and 95% confidence intervals (CI). Results. For women aged 20-24, 25-29, and 30-34 years with prepregnancy depression, the odds of never breastfeeding and breastfeeding 8 weeks or less were significantly higher than in women with no history of prepregnancy depression. Notably, among women aged 25-29 with prepregnancy depression, the odds of never breastfeeding and breastfeeding 8 weeks or less were 93% (adjusted odds ratio (AOR) = 1.93, 95% CI =1.57-2.37) and 65% (AOR = 1.65, 95% CI = 1.37-1.99) higher compared to women with no history of prepregnancy depression, respectively. Conclusions. Having a history of poor mental health before pregnancy may increase the likelihood of premature breastfeeding cessation. A woman’s mental health status before pregnancy should be considered in reproductive and prenatal care models. Efforts should be made to understand challenges women of specific age groups face when trying to breastfeed.

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Early life and socio-economic determinants of dietary trajectories in infancy and early childhood – results from the HSHK birth cohort study

Nutrition Journal ◽

10.1186/s12937-021-00731-3 ◽

2021 ◽

Vol 20 (1) ◽

Author(s):

Narendar Manohar ◽

Andrew Hayen ◽

Loc Do ◽

Jane Scott ◽

Sameer Bhole ◽

...

Keyword(s):

Early Childhood ◽

Cohort Study ◽

Birth Cohort ◽

Early Life ◽

Maternal Education ◽

Multinomial Logistic Regression ◽

Preschool Age ◽

Breastfeeding Duration ◽

Birth Cohort Study ◽

Infancy And Early Childhood

Abstract Background Early childhood is a period when dietary behaviours are established. This study aimed to examine the longitudinal intake of core and discretionary foods and identify early life and socio-economic factors influencing those intakes. Methods Mother-infant dyads (n = 934) from the Healthy Smiles Healthy Kids study, an ongoing birth cohort study, were interviewed. The information on ‘weekly frequency of core and discretionary foods intake’ using a food frequency questionnaire was collected at 4 months, 8 months, 1 year, 2 years and 3 years age points. Group-based trajectory modelling analyses were performed to identify diet trajectories for ‘core’ and ‘discretionary’ foods respectively. A multinomial logistic regression was performed to identify the maternal and child-related predictors of resulting trajectories. Results The intake of core and discretionary foods each showed distinct quadratic (n = 3) trajectories with age. Overall, core foods intake increased rapidly in the first year of life, followed by a decline after age two, whereas discretionary foods intake increased steadily across the five age points. Multiparity (Relative Risk (RR): 0.46, 95%CI: 0.27–0.77), non-English speaking ethnicity of mother (RR: 0.66, 95%CI: 0.47–0.91) and having a single mother (RR: 0.40, 95%CI: 0.18–0.85) were associated with low trajectories of core foods intake whereas older maternal age (RR: 1.05, 95%CI: 1.01–1.08) and longer breastfeeding duration (RR: 1.02, 95%CI: 1.00–1.03) were associated with higher trajectories of core foods intake. Also, multiparity (RR 2.63, 95%CI: 1.47–4.70), low maternal education (RR 3.01, 95%CI: 1.61–5.65), and socio-economic disadvantage (RR 2.69, 95%CI: 1.31–5.55) were associated with high trajectories of discretionary foods intake. Conversely, longer duration of breastfeeding (RR 0.99, 95%CI: 0.97–0.99), and timely introduction of complementary foods (RR 0.30, 95%CI: 0.15–0.61) had a protective effect against high discretionary foods consumption in infancy and early childhood. Conclusion Children’s frequency of discretionary foods intake increases markedly as they transition from infancy to preschool age, and the trajectories of intake established during early childhood are strongly influenced by socio-demographic factors and infant feeding choices. Hence, there is a need for targeted strategies to improve nutrition in early childhood and ultimately prevent the incidence of chronic diseases in children.

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Children’s Health Capital Investment: Effects of U.S. Infant Breastfeeding on Teenage Obesity

Econometrics ◽

10.3390/econometrics9040042 ◽

2021 ◽

Vol 9 (4) ◽

pp. 42

Author(s):

Albert Okunade ◽

Ahmad Reshad Osmani ◽

Toluwalope Ayangbayi ◽

Adeyinka Kevin Okunade

Keyword(s):

Standard Deviation ◽

Capital Investment ◽

Breastfeeding Duration ◽

Development Theory ◽

Breastfeeding Initiation ◽

Obesity Prevalence ◽

Long Term Effects ◽

Health Capital ◽

Initiation Rate ◽

Teenage Obesity

Obesity, as a health and social problem with rising prevalence and soaring economic cost, is increasingly drawing scholarly and public policy attention. While many studies have suggested that infant breastfeeding protects against childhood obesity, empirical evidence on this causal relationship is fragile. Using the health capital development theory, this study exploited multiple data sources from the U.S. and a three-way error components model (ECM) with a jackknife resampling plan to estimate the effect of in-hospital breastfeeding initiation and breastfeeding for durations of 3, 6, and 12 months on the prevalence of obesity during teenage years. The main finding was that a 1% rise in the in-hospital breastfeeding initiation rate reduces the teenage obesity prevalence rate by 1.7% (9.6% of a standard deviation). The magnitude of this effect declines as the infant breastfeeding duration lengthens—e.g., the 12-month infant breastfeeding duration rate is associated with a 0.53% (3.7% of a standard deviation) reduction in obesity prevalence in the teenage years (9th to 12th grades). The study findings agree with both the behavioral and physiological theories on the long-term effects of breastfeeding, and have timely implications for public policies promoting infant breastfeeding to reduce the economic burden of teenage and later adult-stage obesity prevalence rates.

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The Prenatal Rating of Efficacy in Preparation to Breastfeed Scale: A New Measurement Instrument for Prenatal Breastfeeding Self-efficacy

Journal of Human Lactation ◽

10.1177/0890334418799047 ◽

2018 ◽

Vol 35 (1) ◽

pp. 21-31 ◽

Cited By ~ 2

Author(s):

Erin M. McKinley ◽

Linda L. Knol ◽

Lori W. Turner ◽

Joy J. Burnham ◽

Kristine R. Graettinger ◽

...

Keyword(s):

Self Efficacy ◽

Survey Design ◽

Measurement Instrument ◽

Breastfeeding Initiation ◽

Interpersonal Processes ◽

Cross Sectional ◽

Convenience Sample ◽

Breastfeeding Intention ◽

Modifiable Factors ◽

Highly Correlated

Background: Breastfeeding self-efficacy and breastfeeding intention are two modifiable factors that influence rates of breastfeeding initiation. Research Aims: (1) To develop a scale to measure prenatal breastfeeding self-efficacy, and (2) test its psychometric properties by determining the internal consistency and reliability, and (3) assess the relationships between prenatal breastfeeding self-efficacy and breastfeeding intention. Methods: Cross-sectional prospective one-group survey design was used. A convenience sample of pregnant patients attending an obstetrics and gynecology clinic ( N=124) completed a survey at the recruitment site that assessed demographics, breastfeeding intention, and breastfeeding self-efficacy theory constructs. Retest surveys ( n=14) were taken home and returned to the researcher by mail after completion. Results: Cronbach’s alpha for the 39-item scale was .98 (test) and .97 (retest) with an item-to-total correlation range of .54 to .78. A four-factor solution for the scale was retained. Test-retest indicated each factor was significant and highly correlated: Individual Processes (.88, p < .001), Interpersonal Processes (.893, p < .001), Professional Advice (.919, p < .001), and Social Support (.880, p < .001). Overall prenatal breastfeeding self-efficacy score was highly correlated (.610, p <.001) with breastfeeding intention scores. Conclusions: The Prenatal Rating of Efficacy in Preparation to Breastfeed Scale is a valid and reliable measure of a prenatal women’s self-efficacy in preparation to breastfeed. Measuring the level of self-efficacy could alert prenatal women and health professionals to individual skill sets.

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