Modifiable Individual Factors Associated with Breastfeeding: A Cohort Study in China

Breast milk is an ideal first food for infants in the initial months of life. This study aimed to identify modifiable individual factors in breastfeeding during the first six months of life in Hunan. This birth cohort study was conducted in three communities in Changsha, Hunan province. Data were collected through maternal health manuals and self-administered questionnaires during the follow-up period. To find risk factors and calculate odds ratios, generalized estimating equation models were applied. The final study included 951 mother-infant pairs. The prevalence of exclusive breastfeeding and any breastfeeding in this study was below the World Health Organization’s breastfeeding goals. Infant age, passive smoking after delivery, minor postnatal depression, and feeding-bottles were shown to act negatively on both exclusive breastfeeding and any breastfeeding. In addition, cesarean delivery and delayed breastfeeding initiation had adverse effects on exclusive breastfeeding. Multiparas were less likely to continue any breastfeeding during the first few months. This study highlights the importance of screening probable maternal depression during primary care service and reducing secondhand smoke and feeding-bottle use. The results also suggest that healthcare professionals should provide more assistance and education to multiparas and mothers with cesarean delivery or delayed breastfeeding initiation.

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Influences of Cesarean Delivery on Breastfeeding Practices and Duration: A Prospective Cohort Study

Journal of Human Lactation ◽

10.1177/0890334417741434 ◽

2018 ◽

Vol 34 (3) ◽

pp. 526-534 ◽

Cited By ~ 15

Author(s):

Cheng Chen ◽

Yan Yan ◽

Xiao Gao ◽

Shiting Xiang ◽

Qiong He ◽

...

Keyword(s):

Cohort Study ◽

Regression Model ◽

Cesarean Delivery ◽

Vaginal Delivery ◽

Prospective Cohort Study ◽

Exclusive Breastfeeding ◽

Prospective Cohort ◽

Breastfeeding Duration ◽

Breastfeeding Initiation ◽

Breastfeeding Practices

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.

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Early infant feeding practices in Ireland; current and secular analyses of infant feeding in two prospective birth cohort studies

Proceedings of The Nutrition Society ◽

10.1017/s002966512000107x ◽

2020 ◽

Vol 79 (OCE2) ◽

Author(s):

Andrea Hemmingway ◽

Dawn Fisher ◽

Teresa Berkery ◽

Mairead E Kiely

Keyword(s):

Cohort Study ◽

Birth Cohort ◽

Hospital Discharge ◽

Infant Feeding ◽

Infant Formula ◽

Exclusive Breastfeeding ◽

Feeding Practices ◽

World Health ◽

Birth Cohort Study ◽

Infant Feeding Practices

AbstractRecognised as the optimum infant feeding method, breastfeeding affords substantial health benefits to mother and infant. Exclusive breastfeeding is recommended to 6 months, with continuation thereafter. In Ireland, data indicates that 60% breastfeed to any extent at hospital discharge and 40% do so at 3 months. However, nationally collected data is limited in detail, particularly with regard to breastfeeding continuation. The ongoing Cork-based COMBINE birth cohort study recruited 456 participants between 2015 and 2017. Through interviewer-led questionnaires, research midwives collected feeding data at hospital discharge, 1, 2, 4, 6 and 9 months of age. Infant feeding was classed as breast (breastmilk as main milk source), combination (both breastmilk and infant formula daily) or infant formula only feeding. Adherence to the World Health Organisation (WHO) recommendation to exclusively breastfeed (breastmilk only, no infant formula, supplementary fluids or solid foods) was examined longitudinally. To explore secular changes, breastfeeding rates in COMBINE were compared to the BASELINE birth cohort study, which recruited participants (n = 2116) between 2008 and 2011 in the same setting. In COMBINE, 75% of mothers provided any breastmilk (breast or combination) at hospital discharge, of whom 44% breastfed only. Two-fifths (40%), one-third (33%) and one-quarter (24%) breastfed at 1, 4 and 6 months, respectively. Combination feeding of breastmilk and infant formula was prevalent at discharge (31%) and 1 month (20%). Advice from healthcare professionals (31%) and concern baby was hungry (30%) were commonly reported reasons for this practice and throughout the study, mothers who combination fed were more likely to stop breastfeeding altogether than those who breastfed (all P < 0.001). Infant formula only feeding increased from 25% at discharge to 40% at 1 month, 49% at 2 months and 74% at 9 months. Half (45%) of mothers who breastfed did so for less than 4 months and insufficient milk/growth faltering was the most commonly cited reason for cessation (27%). The rate of WHO-defined exclusive breastfeeding was 40% from birth to discharge, 22% to 1 month, 15% to 4 months and 2% to 6 months. The breastfeeding (breastmilk as main milk source) rate at discharge did not differ between our two birth cohorts (44 vs. 40%, P = 0.23), but was significantly higher in COMBINE compared to BASELINE at 2 (36 vs. 27%) and 6 (24 vs. 12%) months (both P < 0.05). While these data provide evidence of some progress towards longer breastfeeding durations, there remains much scope to improve infant feeding practices in Ireland.

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The Study of Asian Women and their Offspring’s Development and Environmental Exposures (SAWASDEE): A northern Thailand birth cohort study (Preprint)

10.2196/preprints.31696 ◽

2021 ◽

Author(s):

Dana Barr ◽

Nancy Fiedler ◽

Tippawan Prapamontol ◽

Panrapee Suttiwan ◽

Warangkana Naksen ◽

...

Keyword(s):

Cohort Study ◽

Birth Cohort ◽

Prenatal Exposure ◽

Environmental Exposures ◽

World Health ◽

Birth Cohort Study ◽

Asian Women ◽

Northern Thailand ◽

Prospective Longitudinal ◽

The Impact

BACKGROUND Prenatal exposure to pesticides have been linked to adverse neurodevelopmental outcomes. Gaps exist in the current literature about the timing and magnitude of exposures that result in these adverse outcomes. OBJECTIVE The Study of Asian Women and their Offspring’s Development and Environmental Exposures (SAWASDEE) Cohort was established to investigate the impact of prenatal exposure to pesticides on neurodevelopment during infancy and early childhood in northern Thailand. METHODS Recruitment of this prospective, longitudinal birth cohort began in July 2017 and was completed in June 2019 in Chom Thong and Fang, two farming districts in Chiang Mai Province in northern Thailand. Follow up of the study participants is on-going. During pregnancy, seven questionnaires were administered. Time-resolved biospecimen samples were collected monthly (for urine) and during each trimester (for blood) at antenatal care visits. Medical records were abstracted. Infants were administered the NICU Network Neurobehavioral Scale (NNNS) test at one month of age. We will complete a number of additional exposure related analyses. RESULTS A total of 1298 women were screened and of those 394 women were enrolled. The mean gestational age at enrollment was 9.9 weeks (STD = 2.6). Differences in literacy were observed between Chom Thong and Fang participants. In Fang about 51% reported being able to read in Thai compared to about 95% in Chom Thong. The percentages were comparable for reporting to be able to write in Thai. A total of 322 mother-child pairs completed the NNNS. CONCLUSIONS This longitudinal birth cohort study will inform risk assessment standards for pregnant women in Thailand and other countries. Building awareness of how insecticide exposure during specific windows of pregnancy affects the neurodevelopmental trajectories of children in developing countries is a specific need recognized by the World Health Organization.

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Evaluation of the impact of breastfeeding support groups in primary health centres in Andalusia, Spain: a study protocol for a cluster randomized controlled trial (GALMA project)

BMC Public Health ◽

10.1186/s12889-020-09244-w ◽

2020 ◽

Vol 20 (1) ◽

Cited By ~ 1

Author(s):

Isabel Rodríguez-Gallego ◽

Fatima Leon-Larios ◽

Cecilia Ruiz-Ferrón ◽

Maria-de-las-Mercedes Lomas-Campos

Keyword(s):

Support Groups ◽

Exclusive Breastfeeding ◽

Intervention Group ◽

World Health ◽

Control Group ◽

Breastfeeding Initiation ◽

Primary Health ◽

Breastfeeding Rate ◽

Breastfeeding Rates ◽

The Impact

Abstract Background In 2003, the World Health Organization recommended exclusive breastfeeding (EB) during the newborn’s first 6 months of life and, if possible, during the first 2 years. However, EB rates resist these recommendations. In developed countries, only 1 out of 3 babies is breastfed during its first 6 months of life, and great differences between areas and countries can be observed. Only 35% of the newborns receive breastfeeding at 3–4 months of age. There are diverse strategies described in the literature that have proven their efficiency in improving breastfeeding rates. It has also been proven that professional support is an effective tool to extend any kind of breastfeeding; besides, it has been observed that mother-to-mother support also increases breastfeeding initiation, sustainment, and exclusive duration. The overall aim of the study is to assess the impact of the support groups on the sustainment of exclusive breastfeeding until 6 months after birth. Methods/design This study is a cluster-random multicentric clinical trial with a control group and an intervention group, without blinding because it is impossible to mask the intervention. A randomization by centres of primary health (clusters) will be carried out. The women allocated to the intervention or control group will be randomized with a simple randomization sampling. The participants’ breastfeeding rate will be followed up at the first 10 days, and at 2, 4, and 6 months of their newborn’s life. Discussion There is a need to assess the impact of mother support groups on exclusive breastfeeding. This study aims to analyse the outcomes related to the support received and to identify what should the structure of these groups be; in other words, to describe factors related to a better breastfeeding experience in order to help women increase breastfeeding rates. Trial registration The trial is prospectively recorded at the ISRCTN registry (Trial ID: ISRCTN17263529). Date recorded: 17/06/2020.

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Diagnosis of overweight and obesity in adolescents from the 1993 Pelotas Birth Cohort Study, Rio Grande do Sul State, Brazil: comparison of two diagnostic criteria

Cadernos de Saúde Pública ◽

10.1590/s0102-311x2007001200020 ◽

2007 ◽

Vol 23 (12) ◽

pp. 2993-2999 ◽

Cited By ~ 4

Author(s):

Maria de Fátima Alves Vieira ◽

Cora Luiza Pavin Araújo ◽

Marilda Borges Neutzling ◽

Pedro Curi Hallal ◽

Ana Maria Baptista Menezes

Keyword(s):

Cohort Study ◽

Birth Cohort ◽

Task Force ◽

High Specificity ◽

Total Sample ◽

Overweight And Obesity ◽

World Health ◽

Birth Cohort Study ◽

Original Cohort ◽

Prevalence Of Obesity

Various cut-off points for body mass index have been proposed to assess nutritional status in adolescents. The aim of this study was to compare two methods for evaluating overweight and obesity. In 2004-5, 4,452 adolescents from the 1993 Pelotas (Brazil) birth cohort study were evaluated, representing 87.5% of the original cohort. Overweight and obesity were evaluated using the methods proposed by the World Health Organization (WHO) and International Obesity Task Force (IOTF). Prevalence of overweight was similar when comparing the two methods (WHO: 23.2%; IOTF: 21.6%). Prevalence of obesity was higher according to the WHO criterion (total sample: 11.6%; boys: 15.1%; girls: 8.2%) as compared to IOTF (total sample: 5.0%; boys: 5.6%; girls: 4.4%). The kappa statistic was around 0.9 for determining overweight and 0.4 for obesity. The IOTF classification showed high specificity in comparison to the WHO criterion for determining overweight and obesity. However, sensitivity was high for overweight but low for obesity. Our data show that the IOTF classification underestimates the prevalence of obesity in early adolescence.

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Breastfeeding cessation in the era of Elimination of Mother to Child Transmission of HIV in Uganda: a retrospective cohort study

10.21203/rs.3.rs-19025/v2 ◽

2020 ◽

Author(s):

Jackslina Gaaniri Ngbapai ◽

Jonathan Izudi ◽

Stephen Okoboi

Keyword(s):

Cohort Study ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Statistical Significance ◽

World Health ◽

Hiv Care ◽

Breastfeeding Initiation ◽

One Year ◽

Postpartum Mothers ◽

Mother To Child

Abstract Background: Among human immunodeficiency (HIV) infected mothers, the World Health Organization (WHO) recommends cessation of breastfeeding at one year to prevent HIV transmission but data are limited. We examined the frequency and factors associated with cessation of breastfeeding at one year among HIV infected postpartum mothers at Ndejje Health Center IV, a large peri-urban health facility in Uganda. Methods: This retrospective cohort study involved all HIV infected postpartum mothers enrolled in HIV care for at least 12 months between June 2014 and June 2018. We abstracted data from registers, held focused group discussions with HIV infected postpartum mothers, and key informant interviews with healthcare providers. Cessation of breastfeeding was defined as the proportion of HIV infected postpartum mothers who had stopped breastfeeding at one year. We summarized quantitative data descriptively, tested differences in outcome with the Chi-square and t-tests, and established independently associated factors using the modified Poisson regression analysis at 5% statistical significance level. We thematically analyzed qualitative data to enrich and triangulate the quantitative results. Results: Of 235 HIV infected postpartum mothers, 150 (63.8%) ceased breastfeeding at one year and this was independently associated with the HIV exposed infant (HEI) being female than male (Adjusted risk ratio (aRR): 1.25, 95% confidence interval (CI), 1.04, 1.50), the mother being multiparous than primparous (aRR, 1.26; 95% CI, 1.04-1.53), and breastfeeding initiation on same-day as birth (aRR, 0.06; 95% CI, 0.01-0.41). Qualitative results showed that partner reminders about breastfeeding adequacy of BF knowledge and maternal literacy facilitated continued breastfeeding until one year. Inadequate breastfeeding knowledge, casual and formal work demands, in addition to increased breastfeeding demand among boys led to cessation of breastfeeding before one year.Conclusion. Cessation of breastfeeding at one year among HIV infected postpartum mothers was suboptimal and this might increase risk of mother to child transmissions of HIV. Cessation of breastfeeding was more likely among female HEIs and multiparous mothers, and less likely when breastfeeding is initiated on same-day as birth. Interventions to enhance cessation of breastfeeding at one year should target groups of women with lower rates.

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