Trends in Breastfeeding Practices and Mothers’ Experience in the French Nutrinet-Santé Cohort.

Author(s):  
Frederic Courtois ◽  
Sandrine Péneau ◽  
Benoît Salavane ◽  
Valentina A Andreeva ◽  
Marie-Françoise Roland-Cachera ◽  
...  

Abstract BackgroundDespite the suggested health benefits of breastfeeding for infants and mothers,France has one of the lowest rates regarding breastfeeding initiation and duration in the world. Fewstudies have been performed concerning the extent of breastfeeding practices in France since themiddle of the 20th century, or regarding the mothers’ practices from initiation to cessation. Thepurpose of our study is to determine trends in breastfeeding over the past decades and to examinemothers’ perceptions about factors known to have an impact on breastfeeding support and cessation.Methods29,953 parous women from the French NutriNet-Santé cohort were included in theprsent study. Using web-questionnaires, they were asked retrospectively if they breastfed or nottheir youngest child, and if so, the duration of the exclusive and total breastfeeding. For those whohad breastfed, we investigated their perceptions about support at initiation and during the entirebreastfeeding period and the reasons for breastfeeding cessation. We also asked those who did notbreastfeed about their perceptions on non-breastfeeding their youngest child and the reasons forchoosing to bottle-fed him or her. Analyses were weighted according to the French census data.Results67.3% of mothers in the NutriNet-Santé cohort breastfed their youngest child. Theproportion of breastfed children increased tover 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. Mean total breastfeeding duration was 4.7months (4.5 – 5.0) while exclusive breastfeeding duration was 2.8 months (2.7 – 2.9). Mothers feltsupported at initiation and over the breastfeeding period. 59.5% of mothers reported a desire to havebreastfed more than 2 months longer. 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%), butalmost half of them would have liked to breastfeed (45.9%).ConclusionBreastfeeding duration has increased in the past decades but did not reach the publichealth recommendations threshold. Other targets than mothers have to be considered, like the fatherand her environment, to increase breastfeeding practices.Trial RegistrationThe study was registered at ClinicalTrials.gov (NCT03335644).

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Frédéric Courtois ◽  
Sandrine Péneau ◽  
Benoît Salanave ◽  
Valentina A. Andreeva ◽  
Marie Françoise Roland-Cachera ◽  
...  

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).


2018 ◽  
Vol 34 (3) ◽  
pp. 526-534 ◽  
Author(s):  
Cheng Chen ◽  
Yan Yan ◽  
Xiao Gao ◽  
Shiting Xiang ◽  
Qiong He ◽  
...  

Background: Mothers are encouraged to exclusively breastfeed for the first 6 months. However, cesarean delivery rates have increased worldwide, which may affect breastfeeding. Research aim: This study aimed to determine the potential effects of cesarean delivery on breastfeeding practices and breastfeeding duration. Methods: This was a 6-month cohort study extracted from a 24-month prospective cohort study of mother–infant pairs in three communities in Hunan, China. Data about participants’ characteristics, delivery methods, breastfeeding initiation, use of formula in the hospital, exclusive breastfeeding, and any breastfeeding were collected at 1, 3, and 6 months following each infant’s birth. The chi-square test, logistic regression model, and Cox proportional hazard regression model were used to examine the relationship between breastfeeding practices and cesarean delivery. Results: The number of women who had a cesarean delivery was 387 (40.6%), and 567 (59.4%) women had a vaginal delivery. The exclusive breastfeeding rates at 1, 3, and 6 months were 80.2%, 67.4%, and 21.5%, respectively. Women who had a cesarean delivery showed a lower rate of exclusive breastfeeding and any breastfeeding than those who had a vaginal delivery ( p < .05). In addition, cesarean delivery was related with using formula in the hospital and delayed breastfeeding initiation. Cesarean delivery also shortened the breastfeeding duration (hazard ratio = 1.40, 95% confidence interval [1.06, 1.84]). Conclusion: Healthcare professionals should provide more breastfeeding skills to women who have a cesarean delivery and warn mothers about the dangers of elective cesarean section for breastfeeding practices.


2020 ◽  
Author(s):  
Christiane Horwood ◽  
Lyn Haskins ◽  
Ingunn Marie Engebretsen ◽  
Catherine Connolly ◽  
Anna Coutsoudis ◽  
...  

Abstract Background KwaZulu-Natal (KZN) Initiative for breastfeeding support (KIBS) was a multipronged intervention to support breastfeeding initiation and sustained breastfeeding implemented between 2014 and 2017. We present results of two surveys conducted before and after KIBS implementation to assess changes in feeding practices in KZN over this time period. Methods Two cross-sectional surveys were conducted in primary health care clinics. Multistage stratified random sampling was used to select clinics and participants. Sample size was calculated to provide district estimates of 14-week exclusive breastfeeding (EBF) rates at baseline (KIBS1), and provincial estimates at endpoint (KIBS2). At KIBS1 the sample required was nine participating clinics in each of 11 districts (99 clinics) with 369 participants per district (N=4059), and at KIBS2 was 30 clinics in KZN with 30 participants per clinic (N=900). All caregivers aged ≥ 15 years attending the clinic with infants aged 13- <16 weeks were eligible to participate. Data was collected using structured interviews on android devices. Multi-variable logistic regression was used to adjust odds ratios for differences between time points. Results At KIBS1 (May2014- March2015), 4172 interviews were conducted with carers, of whom 3659 (87.6%) were mothers. At KIBS2 (January-August 2017), 929 interviews were conducted which included 788 (84.8%) mothers. Among all carers the proportion of EBF was 44.6% and 50.5% (p= 0.1) at KIBS1 and KIBS2 respectively, but greater improvements in EBF were shown among mothers (49.9 vs 59.1: p=0.02). There were reductions in mixed feeding among all infants (23.2% vs 16.3%; p=0.016). Although there was no change in the proportion of carers reporting not breastfeeding (31.9% vs 32.8%; p= 0.2), the duration of breastfeeding among mothers who had stopped breastfeeding was longer at KIBS2 compared to KIBS1 (p=0.0015). Mothers who had returned to work or school were less likely to be breastfeeding (AOR 3.76; 95% CI 3.1-4.6), this was similar among HIV positive mothers (AOR 2.1; 95% CI 1.7-2.6). Conclusion Despite improvements to exclusive breastfeeding, failure to initiate and sustain breastfeeding is a challenge to achieving optimal breastfeeding practices. Interventions are required to address these challenges and support breastfeeding particularly among working mothers and HIV positive mothers.


2020 ◽  
Author(s):  
Christiane Horwood ◽  
Lyn Haskins ◽  
Ingunn Marie Engebretsen ◽  
Catherine Connolly ◽  
Anna Coutsoudis ◽  
...  

Abstract Background KwaZulu-Natal (KZN) Initiative for breastfeeding support (KIBS) was a multipronged intervention to support breastfeeding initiation and sustained breastfeeding implemented between 2014 and 2017. We present results of two surveys conducted before and after KIBS implementation to assess changes in feeding practices in KZN over this time period. Methods Two cross-sectional surveys were conducted in primary health care clinics. Multistage stratified random sampling was used to select clinics and participants. Sample size was calculated to provide district estimates of 14-week exclusive breastfeeding (EBF) rates at baseline (KIBS1), and provincial estimates at endpoint (KIBS2). At KIBS1 the sample required was nine participating clinics in each of 11 districts (99 clinics) with 369 participants per district (N=4059), and at KIBS2 was 30 clinics in KZN with 30 participants per clinic (N=900). All caregivers aged ≥ 15 years attending the clinic with infants aged 13- <16 weeks were eligible to participate. Data was collected using structured interviews on android devices. Multi-variable logistic regression was used to adjust odds ratios for differences between time points. Results At KIBS1 (May2014- March2015), 4172 interviews were conducted with carers, of whom 3659 (87.6%) were mothers. At KIBS2 (January-August 2017), 929 interviews were conducted which included 788 (84.8%) mothers. Among all carers the proportion of EBF was 44.6% and 50.5% (p= 0.1) at KIBS1 and KIBS2 respectively, but greater improvements in EBF were shown among mothers (49.9 vs 59.1: p=0.02). There were reductions in mixed feeding among all infants (23.2% vs 16.3%; p=0.016). Although there was no change in the proportion of carers reporting not breastfeeding (31.9% vs 32.8%; p= 0.2), the duration of breastfeeding among mothers who had stopped breastfeeding was longer at KIBS2 compared to KIBS1 (p=0.0015). Mothers who had returned to work or school were less likely to be breastfeeding (AOR 3.76; 95% CI 3.1-4.6), this was similar among HIV positive mothers (AOR 2.1; 95% CI 1.7-2.6). Conclusion Despite improvements to exclusive breastfeeding, failure to initiate and sustain breastfeeding is a challenge to achieving optimal breastfeeding practices. Interventions are required to address these challenges and support breastfeeding particularly among working mothers and HIV positive mothers.


BMJ Open ◽  
2017 ◽  
Vol 7 (9) ◽  
pp. e016331 ◽  
Author(s):  
Laura Oakley ◽  
Christopher P Baker ◽  
Srivalli Addanki ◽  
Vipin Gupta ◽  
Gagandeep Kaur Walia ◽  
...  

ObjectiveTo investigate whether village-level urbanicity and lower level socioeconomic factors are associated with breastfeeding practices in transitioning rural communities in India.Setting29 villages in Ranga Reddy district, southern India between 2011 and 2014.Participants7848 children under 6 years identified via a cross-sectional household survey conducted as part of the Andhra Pradesh Children and Parents Study.Outcome measuresTwo key indicators of optimal breastfeeding: termination of exclusive breastfeeding before 6 months and discontinuation of breastfeeding by 24 months. Village urbanicity was classified as low, medium or high according to satellite assessed night-light intensity.ResultsBreastfeeding initiation was almost universal, and approximately two in three children were exclusively breastfed to 6 months and a similar proportion breastfed to 24 months. Using multilevel logistic regression, increasing urbanicity was associated with breastfeeding discontinuation before 24 months (medium urbanicity OR 1.45, 95% CI 0.71 to 2.96; high urbanicity OR 2.96, 95% CI 1.45 to 6.05) but not with early (<6 months) termination of exclusive breastfeeding. Increased maternal education was independently associated with both measures of suboptimal breastfeeding, and higher household socioeconomic position was associated with early termination of exclusive breastfeeding.ConclusionIn this transitional Indian rural community, early stage urbanicity was associated with a shorter duration of breastfeeding. Closer surveillance of changes in breastfeeding practices alongside appropriate intervention strategies are recommended for emerging economies.


2018 ◽  
Vol 9 (1) ◽  
Author(s):  
Uke Maharani Dewi

factors that affect the practice of nursing in the mother post section caesarea. Various programs to support the delivery of ASI has intensified coverage of ASI but still does not meet the expected target. Previous studies showed that breastfeeding initiation was late in babies born with sectio caesarea compared to those with vaginal delivery and prevalence of exclusive breastfeeding practice was low in the former group. The objective of this study was to define factors correlated breast feeding practice initiation on post sectio caesarea mother. 72 post sectio caesarea mothers were observed and interviewed on January 2012 to find the factors correlated with breastfeeding practice. The results showed that although 26.4% of them had previous experience in breastfeeding, only 6.9% and 29.2% of total breastfeeding is started on the first and second post sectio caesarea respectively. Support for breastfeeding practice from health workers was low, and there were significant correlation between the support and rooming conditions with breastfeeding practices (p = 0.001).


2019 ◽  
Vol 31 (2) ◽  
pp. 113-120 ◽  
Author(s):  
Raheema Abdul Raheem ◽  
Hui Jun Chih ◽  
Colin William Binns

Objectives: To assess associations between maternal depression and breastfeeding practices in mothers in the Maldives. Design: A prospective cohort study. The validated questionnaires contained information on demographics, breastfeeding initiation, breastfeeding duration, and the Edinburgh Postnatal Depression Scale. Logistic regression analyses were used to assess association between Edinburgh Postnatal Depression Scale score and breastfeeding practices while adjusting for lifestyle determinants. Cox regression was done to measure the association between maternal depression and breastfeeding duration. Settings: Antenatal clinic at Indira Gandhi Memorial and ADK Hospitals in Male’, Maldives. Subjects: A total of 458 mothers from the antennal clinics were interviewed at 36 weeks of gestation and again at 1, 3, and 6 months after birth. Results: Antenatal depression at 36 weeks of gestation was associated with late initiation of breastfeeding (adjusted odds ratio = 3.0, 95% confidence interval = 1.3-6.8). Postnatal depression was associated with shorter duration of exclusive, full, and any breastfeeding ( P < .001). Conclusion. Depression is negatively associated with breastfeeding practices. There is a need to manage antenatal postnatal depression in mothers in order to encourage them to initiate breastfeeding earlier and to breastfeed for longer.


2019 ◽  
Vol 75 (4) ◽  
Author(s):  
Dirk G. Van der Merwe

Throughout its history, Christianity has stood in a dichotomous relation to the various philosophical movements or eras (pre-modernism, modernism, postmodernism and post-postmodernism) that took on different faces throughout history. In each period, it was the sciences that influenced, to a great extent, the interpretation and understanding of the Bible. Christianity, however, was not immune to influences, specifically those of the Western world. This essay reflects briefly on this dichotomy and the influence of Bultmann’s demythologising of the kerygma during the 20th century. Also, the remythologising (Vanhoozer) of the church’s message as proposed for the 21st century no more satisfies the critical Christian thinkers. The relationship between science and religion is revisited, albeit from a different perspective as established over the past two decades as to how the sciences have been pointed out more and more to complement theology. This article endeavours to evoke the church to consider the fundamental contributions of the sciences and how it is going to incorporate the sciences into its theological training and message to the world.


2018 ◽  
Vol 35 (1) ◽  
pp. 100-113 ◽  
Author(s):  
Julia H. Kim ◽  
Jong C. Shin ◽  
Sharon M. Donovan

Background Returning to work is one of the main barriers to breastfeeding duration among working mothers in the United States. However, the impact of workplace lactation programs is unclear. Research Aim The aim of this study was to evaluate the effectiveness of workplace lactation programs in the United States on breastfeeding practices. Methods A systematic search was conducted of seven databases through September 2017. Articles ( N = 10) meeting the inclusion criteria of describing a workplace lactation intervention and evaluation in the United States and measuring initiation, exclusivity, or duration using an experimental or observational study design were critically evaluated. Two reviewers conducted quality assessments and reviewed the full-text articles during the analysis. Results Common services provided were breast pumps, social support, lactation rooms, and breastfeeding classes. Breastfeeding initiation was very high, ranging from 87% to 98%. Several factors were significantly associated with duration of exclusive breastfeeding: (a) receiving a breast pump for one year (8.3 versus 4.7 months), (b) return-to-work consultations (40% versus 17% at 6 months), and (c) telephone support (42% versus 15% at 6 months). Each additional service (except prenatal education) dose-dependently increased exclusively breastfeeding at 6 months. Sociodemographic information including older maternal age, working part-time, longer maternity leave, and white ethnicity were associated with longer breastfeeding duration. Conclusion Workplace lactation interventions increased breastfeeding initiation, duration, and exclusive breastfeeding, with greater changes observed with more available services. More evidence is needed on the impact of workplace support in low-income populations, and the cost-effectiveness of these programs in reducing health care costs.


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