Breast-Feeding Rates Among Black Urban Low-Income Women: Effect of Prenatal Education

Many factors are associated with low breast-feeding rates among black low-income women. This study examines whether, despite such factors, health professionals' prenatal education of black poor women is assoicated with increased breast-feeding rates. Black women born in the United States who attended a midwives prenatal clinic (N = 159) were randomly assigned to two types of prenatal education or were followed up in a control group. All women were interviewed on entry into the study and after delivery of their infants. Women assigned to group classes attended at least one session discussing myths, problems, and benefits of breast-feeding. Women assigned to individual prenatal counseling spoke with a pediatrician or nurse practitioner, who discussed breast-feeding topics similar to those covered in the classes. Women in the control group received no additional prenatal education. The three study groups had significantly different percentages of women who breast-fed (controls 22%, classes 46%, individual sessions 53%). Higher percentages of women in the study groups carried out their prenatal plans to breast-feed (controls 50%, classes 86%, individual sessions 62%) or breast-fed despite prenatal plans to bottle-feed (controls 10%, classes 26%, individual sessions 48%). After multivariable analysis controlling for age, prenatal pians to breast-feed, prior breast-feeding experience, perceived support for breast-feeding, education, gravidity, and employment plans, women in intervention groups had a higher likelihood of breast-feeding than control subjects. These findings suggest that an increase in relatively simple, not-too-time-consuming educational efforts in institutions and offices serving black low-income women might yield significant narrowing of the gap in breast-feeding rates between white affluent women and black low-income women.

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Executive Summary

PEDIATRICS ◽

10.1542/peds.74.4.579 ◽

1984 ◽

Vol 74 (4) ◽

pp. 579-583

Keyword(s):

Developing Countries ◽

Breast Milk ◽

Infant Feeding ◽

Breast Feeding ◽

Maternal Employment ◽

The United States ◽

Attitudinal Factors ◽

Rate Of Increase ◽

Breast Feed ◽

Breast Fed

Domestic Although the rate of breast-feeding is increasing in the United States, it appears that the rate of increase has been much slower among less well educated and economically disadvantaged women. Relatively little is known about the behavioral and attitudinal factors that affect the decisions to breast-feed or to stop if already breast-feeding. Breast-feeding does appear to decrease an infant's risk of gastrointestinal infection and otitis media. The effect of method of infant feeding on risk of other infections and allergic illness is less certain. International The rate of breast-feeding in developing countries appears to have declined, especially among urban women. Although some sociodemographic correlates of infant-feeding choice have been examined, little is known about the behavioral and attitudinal factors that influence choice and duration of infant-feeding practices. Milk insufficiency, maternal employment, and pregnancy frequently are given as reasons for terminating breast-feeding. Rates of gastrointestinal illness are lower among breast-fed infants and when such illness is an important cause of death, infant mortality from this cause appears to be reduced. A randomized clinical trial carried out among high-risk infants found a significantly lower rate of infections among those given breast milk than those fed with infant formula. The evidence of the effect of breast-feeding on respiratory tract and other infections from other studies was less clear. Direct comparison of the growth of predominately breast-fed v artificially fed infants in the same populations from developing countries generally show faster growth for the breast-fed infants for the first 6 months of life. After 6 months, severe growth faltering occurs regardless of the method of feeding. In communities where the nutritional adequacy of supplementary foods is poor, breast milk is an extremely important, high-quality food during the second half of infancy and beyond.

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Normal Serum Bilirubin Levels in the Newborn and the Effect of Breast-Feeding

PEDIATRICS ◽

10.1542/peds.78.5.837 ◽

1986 ◽

Vol 78 (5) ◽

pp. 837-843 ◽

Cited By ~ 12

Author(s):

M. Jeffrey Maisels ◽

Kathleen Gifford

Keyword(s):

Breast Feeding ◽

Bilirubin Level ◽

Serum Bilirubin ◽

Strong Association ◽

The United States ◽

Serum Bilirubin Level ◽

Control Group ◽

Term Infants ◽

Maximum Serum ◽

Breast Fed

We measured the serum bilirubin concentrations in 2,416 consecutive infants admitted to our well-baby nursery. The maximum serum bilirubin concentration exceeded 12.9 mg/dL (221 µmol/L) in 147 infants (6.1%), and these infants were compared with 147 randomly selected control infants with maximum serum bilirubin levels ≤12.9 mg/dL. In 66 infants (44.9%), we identified an apparent cause for the jaundice, but in 81 (55%), no cause was found. Of infants for whom no cause for hyperbilirubinemia was found, 82.7% were breast-fed v 46.9% in the control group (P < .0001). Breast-feeding was significantly associated with hyperbilirubinemia, even in the first three days of life. The 95th percentile for bottle-fed infants is a serum bilirubin level of 11.4 mg/dL v 14.5 mg/dL for the breast-fed population, and the 97th percentiles are 12.4 and 14.8 mg/dL, respectively. Of the formula-fed infants, 2.24% had serum bilirubin levels >12.9 mg/dL v 8.97% of breast-fed infants (P < .000001). When compared with previous large studies, the incidence of "readily visibl" jundice (serum bilirubin level >8 mg/dL) appears to be increasing. The dramatic increase in breast-feeding in the United States in the last 25 years may explain this observation. There is a strong association between breast-feeding and jaundice in the healthy newborn infant. Investigations for the cause of hyperbilirubinemia in healthy breast-fed infants may not be indicated unless the serum bilirubin level exceeds approximately 15 mg/dL, whereas in the bottle-fed infant, such investigations may be indicated if the serum bilirubin exceeds approximately 12 mg/dL. If phototherapy is ever indicated in healthy term infants, the overwhelming majority of such infants are likely to be breast-fed; if breast-feeding is, indeed, the cause of such jaundice, a more appropriate approach to hyperbilirubinemia in the breast-fed infant might be to treat the cause (by temporary cessation of nursing) rather than (using phototherapy to treat) the effect.

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Effect of Formula Supplementation in the Hospital on the Duration of Breast-Feeding: A Controlled Clinical Trial

PEDIATRICS ◽

10.1542/peds.75.3.514 ◽

1985 ◽

Vol 75 (3) ◽

pp. 514-518

Author(s):

Katherine Gray-Donald ◽

Michael S. Kramer ◽

Susan Munday ◽

Denis G. Leduc

Keyword(s):

Clinical Trial ◽

Breast Feeding ◽

Observational Studies ◽

Control Group ◽

Controlled Clinical Trial ◽

Trial Period ◽

Feeding Rates ◽

Early Discontinuation ◽

Restricted Group ◽

Breast Fed

To avoid methodologic pitfalls in previous observational studies linking formula supplementation in the hospital to early discontinuation of breast-feeding, a controlled clinical trial of restricted supplementation was conducted. In a pretrial sample of 621 newborns, a comparison of two "well-baby" nurseries found no differences in either hospital supplementation practices or the proportion of infants still being breast-fed at 4 or 9 weeks postpartum. Restriction of supplementation in one of the nurseries for the trial period (n = 781) did not result in higher breast-feeding rates at 4 or 9 weeks. There was, however, a slightly greater mean percent of birth weight lost in the restricted group (6.0% v 5.1%; P < .001). In examining the control group for evidence of an "observational" association, it was found that infants still breast-feeding at 4 or 9 weeks were far more likely to have been unsupplemented than those no longer being breast-fed. It thus appears that formula supplementation in the hospital is a marker, rather than a cause, of breast-feeding difficulty.

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Breast Feeding Remains a Strong Protection against Infant Infections.

Journal of Islamabad Medical & Dental College ◽

10.35787/jimdc.v8i4.351 ◽

2019 ◽

Vol 8 (4) ◽

pp. 203-207

Author(s):

Shagufta Sohail ◽

Kaneez Fatima ◽

Noshina Riaz

Keyword(s):

Breast Feeding ◽

Study Groups ◽

Cross Sectional Study ◽

P Value ◽

Chi Square ◽

Cross Sectional ◽

Exclusive Breast Feeding ◽

Breast Feed ◽

Significant Difference ◽

Breast Fed

Background: Breast feeding prevents infections in infants. Those who are partially or never breast-fed and receiving bottle feeds are at higher risk of infections as compared to exclusive breast-fed infants. The objectives of this study were to record the effect of exclusive breast feeding versus partial and never breast feeding on infections in infants and also to find an association of infection with type of feed, gestation and vaccination status in infants till six months of age.Material and Methods: A total of 500 Infants were included in this cross-sectional study. Information regarding pattern of feeding and infections was obtained by verbal interview of mother and the questionnaire was filled by the study physician. The outcome evaluated was infections in infants till one year of age. Categorical comparisons were made using chi square test. A ‘p’ value < 0.05 was considered statistically significant.Results: Out of 500 infants, 59.4% were males. About 59.6% were exclusively breast-fed till 6 months of age, 31.2% were partially breast-fed and 9.2% were never breast-fed. In exclusively breast-fed group, 29.5% infants reported infections as compared to 40.4% in partial breast-fed group and 65.2% in never breast-fed infants (P < 0.000). Similarly, 40.6% of infants in exclusively breast-fed group, 55.1% in partial breast feed and 58.7% in the never breast-fed reported infections in 4-6 months of age, which was statistically significant (P = 0.003). There was no significant difference in infection rates among the three study groups in 7-9 (P=0.192) and 10 -12 months (P=0.42) of age.Conclusions: Exclusive breast feeding till six months of age significantly reduces the risk of infections in infancy.

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Breast-feeding initiation and exclusive duration at 6 months by social class – results from the Millennium Cohort Study

Public Health Nutrition ◽

10.1079/phn2004702 ◽

2005 ◽

Vol 8 (4) ◽

pp. 417-421 ◽

Cited By ~ 52

Author(s):

YJ Kelly ◽

RG Watt

Keyword(s):

Cohort Study ◽

Social Class ◽

Breast Feeding ◽

Population Based ◽

Millennium Cohort Study ◽

Feeding Rates ◽

Class Differences ◽

Breast Feed ◽

The Uk ◽

Breast Fed

AbstractObjectivesTo assess breast-feeding initiation and rates of exclusive breast-feeding for the first 6 months after birth, and to examine social class differences in breast-feeding rates.DesignFirst sweep of a longitudinal population-based survey, the Millennium Cohort Study.SettingFour countries of the UK.SubjectsSubjects were 18 125 singletons born over a 12-month period spanning 2000–01. Data were collected by parental interview on the initiation of breast-feeding and exclusivity at 1, 4 and 6 months after birth.ResultsOverall breast-feeding was initiated for 71% of babies, and by 1, 4 and 6 months of age the proportions being exclusively breast-fed were 34%, 3% and 0.3%, respectively. There were clear social class differences and mothers with routine jobs with the least favourable working conditions were more than four times less likely (odds ratio (OR) 0.22, 95% confidence interval (CI) 0.18–0.29) to initiate breast-feeding compared with women in higher managerial and professional occupations. Women in routine jobs were less likely to exclusively breast-feed their infants at 1 month (OR 0.42, 95% CI 0.36–0.50) and 4 months (OR 0.5, 95% CI 0.31–0.77) compared with women in higher managerial and professional occupations.ConclusionsClear social class differences in breast-feeding initiation and exclusivity for the first 4 months were apparent in this large UK sample. By 6 months, less than 1% of babies were being exclusively breast-fed. A co-ordinated multi-faceted strategy is required to promote breast-feeding, particularly among lower-income women.

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Faulty Breast Feeding Practice : A Risk Factor in Malnourished Children

Chattagram Maa-O-Shishu Hospital Medical College Journal ◽

10.3329/cmoshmcj.v14i2.25716 ◽

2015 ◽

Vol 14 (2) ◽

pp. 43-47

Author(s):

Sukhendu Shekhar Sen ◽

Jhulan Das Sharma ◽

Dhananjoy Das ◽

Shahed Iqbal ◽

Md Badruddoza

Keyword(s):

Breast Feeding ◽

Protein Energy Malnutrition ◽

Control Group ◽

Case Group ◽

Feeding Practice ◽

Prelacteal Feeding ◽

College Hospital ◽

Major Health Problem ◽

Protein Energy ◽

Breast Fed

Background: The predominant form of malnutrition is commonly called proteincalorie malnutrition. Protein Energy Malnutrition (PEM) is still a major health problem in children of developing countries including Bangladesh. The causes of malnutrition are multifactorial including nutritional factors, socioeconomic factors, health status of the mothers and repeated infections in children.Objective: To explore the information regarding the breast feeding practices of children suffering from Protein-Energy Malnutrition.Methods: This case control study was conducted in Chittagong Medical College Hospital from November 2006 to April 2007. A total of 65 controls and 65 cases were selected consecutively for the purpose of the study. Their mothers were interviewed with help of structured questionnaire containing all the variables of interest to attain the study objectives. The test statistics used to analyze the data were descriptive statistics and Chi-square (c2) or Fishers Exact Probability Test.Results: A significantly higher frequency of cases (67.7%) were given pre-lacteal feed, predominantly honey and sugar-water compared to control group (41.5%) (p = 0.008). Nearly 100% of controls were given colostrums compared to 75% of the cases. About one-third (31.3%) of the cases was exclusively breast-fed in comparison to 58.5% of the control group (p = 0.003). Over onequarter (27.7%) of the control were breast-fed upto 6 months of age, as opposed to only 1.5% cases (p < 0.001). Duration of predominant breast feeding for more than 6 months of age was also significantly higher in control group than that in case group (p = 0.001). Breast milk substitutes demonstrate their significant presence in cases (38.5%) than that in controls (9%) (p = 0.003).Conclusion: The study showed that rejection of colostrums, practice of prelacteal feeding, delayed initiation of breast feeding, early cessation of exclusive breast feeding and use of formula milk all were significantly higher in the malnourished group of children than those in their normal counterpart.Chatt Maa Shi Hosp Med Coll J; Vol.14 (2); Jul 2015; Page 43-47

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Trends in Breast-Feeding

PEDIATRICS ◽

10.1542/peds.74.4.591 ◽

1984 ◽

Vol 74 (4) ◽

pp. 591-602

Author(s):

Gerry E. Hendershot

Keyword(s):

Infant Feeding ◽

Breast Feeding ◽

Market Research ◽

The United States ◽

Upward Trend ◽

Disadvantaged Women ◽

Breast Feed ◽

Statistical Studies ◽

Low Levels ◽

Short Section

Starting from very high levels in the 1940s, breast-feeding declined steadily to low levels in the early 1970s, and then began an upward trend which has apparently continued until the present (Fig. 1). In the 1940s, breast-feeding was more common among disadvantaged women. The subsequent decline was also more rapid among the disadvantaged, however, so that by the early 1970s, disadvantaged women were considerably less likely than others to breast-feed. Because the increase since the early 1970s has not been so pronounced among the disadvantaged, they continue to have relatively low levels of breast-feeding. The causes of these trends and differentials are not well understood. These are the principal conclusions drawn from a review of statistical studies of trends and differentials in breast-feeding in the United States. The studies included national health surveys conducted by the federal government, market research surveys conducted by infant formula manufacturers, and infant feeding surveys conducted by medical researchers. The studies differed markedly in their methods—a fact that affects their validity, reliability, and comparability. The first section of this paper discusses these data sources and their limitations. The next two sections discuss the downward trend in breast-feeding from the 1940s to the early 1970s, and the upward trend since. Each of these sections examines demographic differences in these trends. A short section that addresses possible causes of the trends and differentials follows those two sections. SOURCES AND LIMITATIONS OF THE DATA The principal sources of data on trends and differentials in breast-feeding are national fertility surveys, market research surveys, and special purpose infant-feeding surveys.

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Recent Declines in Breast-Feeding in the United States, 1984 Through 1989

PEDIATRICS ◽

10.1542/peds.88.4.719 ◽

1991 ◽

Vol 88 (4) ◽

pp. 719-727 ◽

Cited By ~ 1

Author(s):

Alan S. Ryan ◽

David Rush ◽

Fritz W. Krieger ◽

Gregory E. Lewandowski

Keyword(s):

United States ◽

Birth Weight ◽

Breast Feeding ◽

College Education ◽

The United States ◽

Sociodemographic Factors ◽

Infants And Children ◽

Supplemental Food ◽

White Ethnicity ◽

Breast Feed

Ongoing surveys performed by Ross Laboratories demonstrate recent declines both in the initiation of breast-feeding and continued breast-feeding at 6 months of age. Comparing rates in 1984 and 1989, the initiation of breast-feeding declined approximately 13% (from 59.7% to 52.2%), and there was a 24% decline in the rate of breast-feeding at 6 months of age (from 23.8% to 18.1%). The decline in breast-feeding was seen across all groups studied but was greater in some groups than in others. Logistic regression analysis indicates that white ethnicity, some college education, increased maternal age, and having an infant of normal birth weight were all positively associated with the likelihood of both initiating breast-feeding and continuing to breast-feed to at least 6 months of age. Women who were black and who were younger, no more than high school educated, enrolled in the Women, Infants and Children supplemental food program, working outside the home, not living in the western states, and who had an infant of low birth weight were less likely either to initiate breast-feeding or to be nursing when their children were 6 months of age. The factors influencing the decline in breast-feeding were not uniform. There were fewer sociodemograpahic factors associated with the decline in the initiation of breast-feeding than in the decline in prolonged breast-feeding. While the disparity between older and younger mothers in initiating breast-feeding increased, there was an offsetting trend as the disparity associated with parity decreased. The only other significantly changed relationship for initiation of breast-feeding was that the disparity associated with higher income increased significantly: the decline in the rates of breast-feeding among the less affluent was greater than among the more affluent. Many more sociodemographic factors were significantly associated with declines in breast-feeding at 6 months of age. The disparity between those mothers not employed and those employed increased (from an odds ratio of 1.65 in 1984 to 2.43 in 1989). The disparities associated with age and parity both increased over time: the rate of breast-feeding declined more steeply among younger and primiparous mothers than among older and multiparous mothers. Similarly, the declines were greater among those enrolled in the Women, Infants and Children program (compared with those not enrolled), those with less than a college education (compared with some college education), and those not residing in the western region of the United States (compared with those residing in the West). Educational efforts to promote breast-feeding are needed for all pregnant women and should be particularly directed toward the groups who have experienced the most rapid recent decline in the rates of breast-feeding.

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PENGARUH SARI KURMA TERHADAP PROLAKTIN DAN PENGELUARAN ASI PADA IBU POSTPARTUM DI BPM PIPIN HERIYANTI YOGYAKARTA TAHUN 2017

Media Ilmu Kesehatan ◽

10.30989/mik.v6i3.196 ◽

2019 ◽

Vol 6 (3) ◽

pp. 195-198

Author(s):

Dwi Yulinda ◽

Imroatul Azizah

Keyword(s):

Treatment Group ◽

Breast Milk ◽

Breast Feeding ◽

Date Palm ◽

Antioxidant Properties ◽

Control Group ◽

Feeding Rates ◽

Palm Fruit ◽

Exclusive Breast Feeding ◽

Palm Fruits

Background: Breastfeeding is exceptionally superior, giving mother and infants distinct and subtastial physical, mental, and developmental health advantages. Palm fruit has content of phytonutrients with antioxidant properties and galactagogues to help increase their milk supply in the early postpatum days. The lowest exclusive brest feeding rates in DIY is in the city of Yogyakarta. Exclusive breast feeding improves infant immunity so as to minimize the occurrence of diarrhea, constipation, fever that is caused by some allergic reactions. Objectifive: :This study aimed to analyze the relationship between date palm fruits on postpartum to prolactin and volume of breast milk Method: Research was conducted on maternal postpartum which is divided into two groups. They are the control group; and the treatment group which was given dates palm fruit. Breast milk volume and prolactin was measured at 3 day after labor. The analytical method used is Student T-test. Results: Date Palm fruits increased prolactin and volume of breast milk which was significantly on firstweek breastfeeding increase in the treatment group compared to the control group at p <0.05. Conclusion: Date Palm fruits is one of the alternatives that can be done to improve the success of exclusive breast feeding on postpartum. Key Words: Date palm fruit, postpartum, prolactin and volume of breast milk

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EXCLUSIVE BREAST FEEDING

The Professional Medical Journal ◽

10.29309/tpmj/2010.17.02.2384 ◽

2010 ◽

Vol 17 (02) ◽

pp. 286-290

Author(s):

SOHAIL ASLAM ◽

FAROOQ AKRAM ◽

MEHBOOB SULTAN

Keyword(s):

Breast Feeding ◽

Feeding Practice ◽

Care Hospital ◽

Cross Sectional ◽

Exclusive Breast Feeding ◽

Lower Socioeconomic ◽

Primary Care Hospital ◽

Breast Feed ◽

Study Setting ◽

Breast Fed

Objective To study the duration and factors influencing exclusive breast feeding practice. Design: A cross sectional descriptive study Setting: A primary care hospital Gilgit, northern area of Pakistan. Period: Ten months from March 2007 to December 2007. Material & Method This study include 125 mothers with mean age of 24.3 years (SD 4.8),37% were illiterate while only 14% were matriculate or above among 125 babies (male 61%: female 39%). Results Out of total 125, eighty one (64.8%) babies were exclusively breast fed (EBF) for first six months of life and only five(4%) infants were not given breast milk at all . among 76 male infants ,52 (68.4%) were EBF for six months in comparison to 29 female (59.2%) out of 49. among 36 first born infants only 15 (41.7%) were EBF for six months in comparison to 66 (74.2%)out of 89 not first born(p<0.05). Conclusion: Exclusive breast feeding for complete 6 months is still not routinely practised by most of mothers and first born are deprived of this right in majority lower socioeconomic group and illiterate mothers are more likelyto breast feed, gender bias was also observed as a significantly high percentage of male babies were observed to be breast fed as compared to females. More efforts are required by health depart. And NGO’s to promote good breast feeding practices in our setup.

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