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Lancet (London, England) Feb 2023In this Series paper, we examine how mother and baby attributes at the individual level interact with breastfeeding determinants at other levels, how these interactions... (Review)
Review
In this Series paper, we examine how mother and baby attributes at the individual level interact with breastfeeding determinants at other levels, how these interactions drive breastfeeding outcomes, and what policies and interventions are necessary to achieve optimal breastfeeding. About one in three neonates in low-income and middle-income countries receive prelacteal feeds, and only one in two neonates are put to the breast within the first hour of life. Prelacteal feeds are strongly associated with delayed initiation of breastfeeding. Self-reported insufficient milk continues to be one of the most common reasons for introducing commercial milk formula (CMF) and stopping breastfeeding. Parents and health professionals frequently misinterpret typical, unsettled baby behaviours as signs of milk insufficiency or inadequacy. In our market-driven world and in violation of the WHO International Code for Marketing of Breast-milk Substitutes, the CMF industry exploits concerns of parents about these behaviours with unfounded product claims and advertising messages. A synthesis of reviews between 2016 and 2021 and country-based case studies indicate that breastfeeding practices at a population level can be improved rapidly through multilevel and multicomponent interventions across the socioecological model and settings. Breastfeeding is not the sole responsibility of women and requires collective societal approaches that take gender inequities into consideration.
Topics: Infant; Infant, Newborn; Humans; Female; Breast Feeding; Milk Substitutes; Mothers; Marketing; Poverty
PubMed: 36764313
DOI: 10.1016/S0140-6736(22)01932-8 -
Pediatrics Jun 2019Pregnancy, infancy, and toddlerhood are sensitive times in which families are particularly vulnerable to household food insecurity and when disparities in child obesity... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND AND OBJECTIVES
Pregnancy, infancy, and toddlerhood are sensitive times in which families are particularly vulnerable to household food insecurity and when disparities in child obesity emerge. Understanding obesity-promoting infant-feeding beliefs, styles, and practices in the context of food insecurity could better inform both food insecurity and child obesity prevention interventions and policy guidelines.
METHODS
We performed purposive sampling of low-income Hispanic mothers ( = 100) with infants in the first 2 years of life, all of whom were participants in a randomized controlled trial of an early child obesity prevention intervention called the Starting Early Program. Bilingual English-Spanish interviewers conducted semistructured qualitative interviews, which were audio recorded, transcribed, and translated. By using the constant comparative method, transcripts were coded through an iterative process of textual analysis until thematic saturation was reached.
RESULTS
Three key themes emerged: (1) contributors to financial strain included difficulty meeting basic needs, job instability, and high vulnerability specific to pregnancy, infancy, and immigration status; (2) effects on infant feeding included decreased breastfeeding due to perceived poor maternal diet, high stress, and limiting of healthy foods; and (3) coping strategies included both home- and community-level strategies.
CONCLUSIONS
Stakeholders in programs and policies to prevent poverty-related disparities in child obesity should consider and address the broader context by which food insecurity is associated with contributing beliefs, styles, and practices. Potential strategies include addressing misconceptions about maternal diet and breast milk adequacy, stress management, building social support networks, and connecting to supplemental nutrition assistance programs.
Topics: Adult; Breast Feeding; Child, Preschool; Female; Food Supply; Hispanic or Latino; Hospitals, Public; Humans; Infant; Male; Mothers; Pediatric Obesity; Poverty; Pregnancy
PubMed: 31088893
DOI: 10.1542/peds.2018-4113 -
Hospitals Jul 1970
Topics: Food Service, Hospital; Health Education; New York City; Nutritional Physiological Phenomena; Poverty; Social Welfare
PubMed: 5423926
DOI: No ID Found -
International Journal of Environmental... Jan 2021The process of feeding is complex and highly dependent on parent, child, social, and environmental factors. Given the rising rates of food insecurity and concomitant... (Review)
Review
The process of feeding is complex and highly dependent on parent, child, social, and environmental factors. Given the rising rates of food insecurity and concomitant poor nutrition and health, the purpose of this article was to outline the important and complex ways in which the context of food insecurity can impact parent feeding practices. Key factors discussed here include the impact of food insecurity on: expectations for motherhood, structural constraints, stress and depression, parents' perceptions of health and child weight, and intergenerational transmission of parent feeding practices. Future research needs are also identified and discussed.
Topics: Body Weight; Child; Feeding Behavior; Food Insecurity; Food Supply; Humans; Poverty
PubMed: 33418887
DOI: 10.3390/ijerph18020366 -
Science (New York, N.Y.) Oct 2007
Topics: Agriculture; Edible Grain; Food Supply; Humans; Hunger; Poverty
PubMed: 17947551
DOI: 10.1126/science.1151062 -
International Journal of Environmental... May 2022Parental feeding practices and styles influence child diet quality and growth. The extent to which these factors have been assessed in the context of disadvantage,... (Review)
Review
Parental feeding practices and styles influence child diet quality and growth. The extent to which these factors have been assessed in the context of disadvantage, particularly household food insecurity (HFI), is unknown. This is important, as interventions designed to increase responsive practices and styles may not consider the unique needs of families with HFI. To address this gap, a scoping review of studies published from 1990 to July 2021 in three electronic databases was conducted. A priori inclusion criteria were, population: families with children aged 0-5 years experiencing food insecurity and/or disadvantage; concept: parental feeding practices/behaviours/style; and context: high income countries. The search identified 12,950 unique papers, 504 full-text articles were screened and 131 met the inclusion criteria. Almost all the studies (91%) were conducted in the United States with recruitment via existing programs for families on low incomes. Only 27 papers assessed feeding practices or styles in the context of HFI. Of the eleven interventions identified, two assessed the proportion of participants who were food insecure. More research is required in families outside of the United States, with an emphasis on comprehensive and valid measures of HFI and feeding practices. Intervention design should be sensitive to factors associated with poverty, including food insecurity.
Topics: Child; Cross-Sectional Studies; Feeding Behavior; Food Insecurity; Food Supply; Humans; Poverty; United States
PubMed: 35564998
DOI: 10.3390/ijerph19095604 -
Appetite Jul 2019The objective of this study was to explore barriers and facilitators to healthy eating among low-income Latino adolescents using an intervention development framework.
OBJECTIVE
The objective of this study was to explore barriers and facilitators to healthy eating among low-income Latino adolescents using an intervention development framework.
METHODS
Semi-structured interviews (n = 30) were conducted with Latino youth ages 13-17 who had overweight or obesity at a safety-net clinic in San Francisco, CA. Adolescent beliefs and attitudes regarding healthy eating and individual, family, and community level barriers and facilitators were elicited. Interviews were analyzed using an inductive approach and the Capability-Opportunity-Motivation (COM-B) model.
RESULTS
Participants had capability gaps; while they demonstrated basic nutrition knowledge, they also held significant misconceptions about healthy eating, equating "organic" with healthy and failing to recognize sugar in a number of beverages and foods. Families were a source of support through role modeling and purchasing fresh produce, yet in many cases also undermined adolescents' healthy eating goals through purchases of high calorie low nutrient food, an opportunity facilitator and challenge. By contrast, peers were mostly a negative influence due to frequent consumption of high calorie low nutrient food. The school environment posed opportunity challenges as participants found school lunch unpalatable and had ready access to unhealthy options nearby. Participants were motivated to improve their eating habits but often not resilient in the face of obstacles.
CONCLUSIONS
Interventions to promote healthy eating among low-income Latino adolescents should address common nutritional misconceptions, target families as well as teens, consider peer influences, and advocate for policy approaches that improve the school food environment.
Topics: Adolescent; Diet, Healthy; Feeding Behavior; Female; Focus Groups; Food Preferences; Health Knowledge, Attitudes, Practice; Hispanic or Latino; Humans; Interviews as Topic; Male; Nutritional Status; Pediatric Obesity; Poverty; San Francisco
PubMed: 30954634
DOI: 10.1016/j.appet.2019.04.004 -
Journal of Tropical Pediatrics Feb 1994HIV-1 infection may be transmitted by breast-feeding. The risk of vertical transmission varies with the stage of maternal infection, but is 29 per cent if a mother... (Review)
Review
HIV-1 infection may be transmitted by breast-feeding. The risk of vertical transmission varies with the stage of maternal infection, but is 29 per cent if a mother acquires infection during lactation. The risk of infant death by not breast-feeding in a poor and contaminated environment is greater than the risk of HIV-infection when an HIV-positive mother breast-feeds. Vertical transmission can be reduced if women avoid high risk activities during pregnancy and especially lactation.
Topics: Africa; Americas; Asia; Breast Feeding; Europe; Female; HIV Infections; HIV-1; Humans; Infant; Infant Food; Infant Mortality; Mothers; Poverty; Risk Factors
PubMed: 7514231
DOI: 10.1093/tropej/40.1.6 -
Frontiers in Public Health 2020The creation of Human Capital is dependent upon good health and education throughout the first 8,000 days of life, but there is currently under-investment in health and...
The creation of Human Capital is dependent upon good health and education throughout the first 8,000 days of life, but there is currently under-investment in health and nutrition after the first 1,000 days. Working with governments and partners, the UN World Food Program is leading a global scale up of investment in school health, and has undertaken a strategic analysis to explore the scale and cost of meeting the needs of the most disadvantaged school age children and adolescents in low and middle-income countries globally. Of the 663 million school children enrolled in school, 328 million live where the current coverage of school meals is inadequate (<80%), of these, 251 million live in countries where there are significant nutrition deficits (>20% anemia and stunting), and of these an estimated 73 million children in 60 countries are also living in extreme poverty (
feeding is USD 4.7 billion, increasing to USD 5.8 billion annually if other essential school health interventions are included in the package. The DCP3 (Vol 8) school feeding edition and the global coverage numbers were launched in Tunis, 2018 by the WFP Executive Director, David Beasley. These estimates continue to inform the development of WFP's global strategy for school feeding. Topics: Adolescent; Africa; Child; Growth Disorders; Humans; Income; Poverty; Schools
PubMed: 33344395
DOI: 10.3389/fpubh.2020.530176 -
Bulletin of the World Health... 1989A study of breast-feeding practices over the first 6 months of life among a cohort of urban poor infants in southern Brazil indicated that the median duration of...
A study of breast-feeding practices over the first 6 months of life among a cohort of urban poor infants in southern Brazil indicated that the median duration of breast-feeding was 18 weeks, and at 6 months 41% of the infants were still being breast-fed. The duration of breast-feeding was significantly associated with the following: the infant's sex, mother's colour, type of first feed, timing of the first breast-feed, breast-feeding regimen and frequency of breast-feeding at 1 month, and the use of hormonal contraceptives by the mother. The following were significant risk factors for early termination of breast-feeding: the infant's sex, type of first feed, use of supplementary feeds, frequency of breast-feeding, feeding regimen, weight-for-age, and weight-for-age after controlling for birth weight. Dissatisfaction with their infant's growth rate was the most frequent reason given by mothers for supplementing the diets of infants who were exclusively breast-fed in the first 3 months of life. Also, the mothers' perception that their milk output was inadequate was the most frequent reason expressed for stopping breast-feeding in the first 4 months. The roles of health services and family support in providing favourable conditions for increasing the duration of breast-feeding in the study population are discussed, as well as the possibility of bias being introduced into studies of the relationship between infant feeding and growth by the effect of the infant's rate of growth on the mother's decision to continue breast-feeding.
Topics: Adult; Brazil; Breast Feeding; Female; Humans; Infant; Male; Mothers; Poverty Areas; Urban Population
PubMed: 2743537
DOI: No ID Found