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International Breastfeeding Journal May 2024Despite growing evidence of the impacts of exclusively breastfeeding infants during the first 6 months of life on preventing childhood infections and ensuring optimal...
Effect of exclusive breastfeeding and other infant and young child feeding practices on childhood morbidity outcomes: associations for infants 0-6 months in 5 South Asian countries using Demographic and Health Survey data.
BACKGROUND
Despite growing evidence of the impacts of exclusively breastfeeding infants during the first 6 months of life on preventing childhood infections and ensuring optimal health, only a small number of studies have quantified this association in South Asia.
METHODS
We analyzed data from the Demographic and Health Surveys in Afghanistan (2015; n = 3462), Bangladesh (2017-2018; n = 1084), India (2019-2021; n = 26,101), Nepal (2022; n = 581), and Pakistan (2017-2018; n = 1,306), including babies aged 0-6 months. Multivariate logistic regression models were used to determine the association between exclusive breastfeeding in the last 24 h and diarrhoea, acute respiratory infections, and fever in the two weeks before the survey. We also examined the association between other infant and young feeding indicators and these outcomes.
RESULTS
Infants who were exclusive breastfed had decreased odds of diarrhoea in Afghanistan (AOR: 0.49, 95% CI 0.35, 0.70), India (AOR: 0.80, 95% CI 0.70, 0.91), and Nepal (AOR: 0.42, 95% CI 0.20, 0.89). Compared with infants who were not exclusive breastfed, infants who were exclusively breastfed were less likely to have fever in Afghanistan (AOR: 0.36, 95% CI 0.26, 0.50) and India (AOR: 0.75, 95% CI 0.67, 0.84). Exclusive breastfeeding was associated with lower odds of acute respiratory infections in Afghanistan (AOR: 0.57, 95% CI 0.39, 0.83). Early initiation of breastfeeding was protective against diarrhoea in India. Bottle feeding was a risk factor for diarrhoea in India and for fever in Afghanistan and India. Bottle feeding was also a risk factor for acute respiratory infection in Afghanistan and India.
CONCLUSIONS
Not exclusive breastfeeding is a risk factor for diarrhoea, acute respiratory infections, and fever in some South Asian countries. These findings could have substantial implications for global and national efforts to increase exclusive breastfeeding rates. More support, advocacy, and action are required to boost breastfeeding rates as a crucial public health measure.
Topics: Humans; Breast Feeding; Infant; Infant, Newborn; Female; Male; Respiratory Tract Infections; Health Surveys; Fever; Adult; Diarrhea; Young Adult; Morbidity; India; Adolescent; Nepal; Pakistan
PubMed: 38755734
DOI: 10.1186/s13006-024-00644-x -
Journal of Health, Population, and... May 2024Even if there is currently no research on food integration practices, there is an unreliable hole in the data for the first motives, especially 6 to 24 months, research...
BACKGROUND
Even if there is currently no research on food integration practices, there is an unreliable hole in the data for the first motives, especially 6 to 24 months, research at ages varies in different ways, always, but the child's development affects an important part of both the child and the parents. This gap limits our comprehensive knowledge of strategic choices and-their potential impact on children's overall health and well-being. Therefore, the aim of this study was factors shaping complementary feeding for 6 to 24-Month-Olds in Northeast Ethiopia.
METHODS
A community-based survey was conducted in northeastern Ethiopia from June to July 2022. A sample of 409 mothers with infants aged 6 to 24 months was selected using a simple random sampling method. A structured questionnaire was adopted and data were collected by an interviewer. Collected data were entered into Epi Data version 4.6 and subsequently converted to SPSS version 21 for further analysis. Variables with a P-value < = 0.25 in the bivariate analysis were included in the multivariable logistic regression model. Multivariable logistic regression analyses aimed at identifying independent associations between early initiation of supplement feeding and determinants-adjusted odds ratios with corresponding 95% confidence intervals were calculated to determine the strength of associations. P-values less than or equal to 0.05 were considered statistically significant.
RESULTS
A total of 409 mothers with their children were included in the analysis, revealing a prevalence of 38.1% for early initiation of complementary feeding among children aged 6-24 months. Factors associated with -early initiation included place of residence (Adjusted Odds Ratio (AOR) 3.63, 95% Confidence Interval (CI) 1.1-11.95), husband's educational status (AOR 16.83, 95% CI 1.98-24.8), maternal occupation (AOR 21.2, 95% CI 1.11-46.9), number of antenatal care (ANC) visits (AOR 25.94, 95% CI 22.7-85.67), initial breastfeeding time (AOR 4.98, 95% CI 1.22-14.9), and medical illness (AOR 2.81, 95% CI 1.12-3.6.
CONCLUSION
Significant associations with Complementary Feeding were identified with the number of antenatal care (ANC) visits, postnatal care (PNC) check-ups, current residency, breastfeeding initiation time, maternal medical illness, and occupational status. To mitigate the early initiation of complementary feeding, it is recommended to enhance ANC/PNC services and educate mothers about the precise timing for introducing complementary foods to their infants.
Topics: Humans; Ethiopia; Infant; Female; Infant Nutritional Physiological Phenomena; Male; Adult; Mothers; Child, Preschool; Breast Feeding; Surveys and Questionnaires; Young Adult; Cross-Sectional Studies; Health Knowledge, Attitudes, Practice; Feeding Behavior
PubMed: 38755695
DOI: 10.1186/s41043-024-00554-y -
BMC Medical Ethics May 2024The involvement of pregnant women in vaccine clinical trials presents unique challenges for the informed consent process. We explored the expectations and experiences of...
BACKGROUND
The involvement of pregnant women in vaccine clinical trials presents unique challenges for the informed consent process. We explored the expectations and experiences of the pregnant women, spouses/partners, health workers and stakeholders of the consent process during a Group B Streptococcus maternal vaccine trial.
METHODS
We interviewed 56 participants including pregnant women taking part in the trial, women not in the trial, health workers handling the trial procedures, spouses, and community stakeholders. We conducted 13 in-depth interviews and focus group discussions with 23 women in the trial, in-depth interviews with 5 spouses, and 5 women not in the trial, key informant interviews with 5 health workers and 5 other stakeholders were undertaken.
RESULTS
Decision-making by a pregnant woman to join a trial was done in consultation with spouse, parents, siblings, or trusted health workers. Written study information was appreciated by all but they suggested the use of audio and visual presentation to enhance understanding. Women stressed the need to ensure that their male partners received study information before their pregnant partners joined a clinical trial. Confidentiality in research was emphasised differently by individual participants; while some emphasised it for self, others were keen to protect their family members from being exposed, for allowing them to be involved in research. However, others wanted their community participation to be acknowledged.
CONCLUSION
We found that pregnant women make decisions to join a clinical trial after consulting with close family. Our findings suggest the need for an information strategy which informs not only the pregnant woman, but also her family about the research she is invited to engage in.
Topics: Humans; Female; Pregnancy; Uganda; Informed Consent; Qualitative Research; Adult; Pregnant Women; Decision Making; Breast Feeding; Male; Spouses; Focus Groups; Clinical Trials as Topic; Streptococcal Infections; Confidentiality; Research Subjects; Young Adult; Health Personnel; Streptococcus agalactiae
PubMed: 38755578
DOI: 10.1186/s12910-024-01055-7 -
PloS One 2024Early initiation of breastfeeding (EIBF), within the first hour of birth, is crucial for promoting exclusive breastfeeding and establishing optimal nursing practices....
BACKGROUND
Early initiation of breastfeeding (EIBF), within the first hour of birth, is crucial for promoting exclusive breastfeeding and establishing optimal nursing practices. However, global EIBF rates remain low, with even lower rates observed in Africa. Despite existing research gaps, this study aims to determine the prevalence of EIBF and identify maternal and child-related factors associated with its practice in West Africa.
METHODS
This study utilized West African Demographic and Health Survey (DHS) data from 13 countries, including 146,964 children's records. To assess model fit, likelihood test and deviance were used. Similarly, intraclass correlation coefficient, median odds ratio, and proportional change in variance were employed for random effect. A multilevel logistic regression model was used to identify individual- and community-level factors influencing EIBF due to the hierarchical nature of the data. Variables with p-values ≤0.2 in the binary model and <0.05 in the final analysis were considered significantly associated with EIBF.
RESULTS
The pooled prevalence of EIBF in West African nations was 50.60% (95% CI; 50.34-50.85%). The highest prevalence rate was observed in Serra Leone (75.33%) and the lowest prevalence was found in Senegal (33.94%). In the multilevel multiple logistic regression model, maternal education (AOR = 1.10, 95% CI, 1.03,1.16), marital status AOR = 1.07, 95% CI, 1.01,1.13), birth weight (AOR = 0.91, CI 0.86,0.96), birth orders (AOR = 1.09, CI 1.03,1.16), and (AOR = 1.11, CI 1.03,1.19), place of residence (AOR = 1.14, CI 1.07,1.21), and mode of delivery type (AOR = 0.26, CI 0.24,0.29) were significantly correlated with EIBF in West Africa.
CONCLUSIONS
The incidence of EIBF in West Africa was found to be low. The study emphasizes the need for targeted behavioral change communication programs to address timely breastfeeding initiation, specifically targeting mothers and child characteristics. Factors such as education, delivery mode, marital status, birth weight, birth order, and place of residence were significantly associated with EIBF. Special attention should be given to improving EIBF rates among women undergoing caesarean sections, infants with low birth weight, and primiparous mothers, along with structural improvements in the healthcare sector in West Africa.
Topics: Humans; Breast Feeding; Female; Africa, Western; Adult; Multilevel Analysis; Health Surveys; Infant, Newborn; Young Adult; Male; Adolescent; Infant; Logistic Models; Prevalence; Mothers; Socioeconomic Factors
PubMed: 38753614
DOI: 10.1371/journal.pone.0302143 -
JPMA. the Journal of the Pakistan... Apr 2024To determine the characteristics and risk factors of breast cancer patients in a tertiary care setting.
OBJECTIVE
To determine the characteristics and risk factors of breast cancer patients in a tertiary care setting.
METHODS
The retrospective, cross-sectional study was conducted at the Sindh Institute of Urology and Transplantation, Karachi, and comprised data of all patients diagnosed with breast cancer from March 2017 to December 2021. Demographic characteristics, clinical presentation, stage of the disease and histopathological characteristics were noted. Data related to all the variables was not available in all cases. Data was analysed using SPSS 23.
RESULTS
Of the 690 patients, 683(99%) were females and 7(1%) were males. The mean age at presentation was 49.3±13.5 years, while the mean duration of symptoms was 10.24±17.64) months. Most of the females were married 642(93%) and multiparous 484(70.9%), while 293(42.5%) had breastfed their children for >1 year, and 412(59.7%) had no history of contraception use. The most common stage at presentation was stage II (48.6%), and most patients had grade II 395(57.2%) invasive ductal carcinoma, with Luminal A molecular subtype noted in 287(41.6%) cases.
CONCLUSIONS
The characteristics of breast cancer in the sample had certain distinctions compared to other populations. It is important to integrate all datasets and develop guidelines appropriate to Pakistani population.
Topics: Humans; Female; Breast Neoplasms; Cross-Sectional Studies; Pakistan; Middle Aged; Risk Factors; Adult; Retrospective Studies; Male; Neoplasm Staging; Breast Neoplasms, Male; Breast Feeding; Carcinoma, Ductal, Breast; Parity; Aged; Neoplasm Grading; Marital Status
PubMed: 38751260
DOI: 10.47391/JPMA.9360 -
BMC Pregnancy and Childbirth May 2024In the U.S., employees often return to work within 8-12 weeks of giving birth, therefore, it is critical that workplaces provide support for employees combining...
BACKGROUND
In the U.S., employees often return to work within 8-12 weeks of giving birth, therefore, it is critical that workplaces provide support for employees combining breastfeeding and work. The Affordable Care Act requires any organization with more than 50 employees to provide a space other than a restroom to express breastmilk and a reasonable amount of time during the workday to do so. States and worksites differ in the implementation of ACA requirements and may or may not provide additional support for employees combining breastfeeding and work. The purpose of this study was to conduct an analysis of the policies and resources available at 26 institutions within a state university system to support breastfeeding when employees return to work after giving birth.
METHODS
Survey data was collected from Well-being Liaisons in the human resources departments at each institution. In addition, we conducted a document review of policies and online materials at each institution. We used univariate statistics to summarize survey results and an inductive and deductive thematic analysis to analyze institutional resources available on websites and in policies provided by the liaisons.
RESULTS
A total of 18 (65.3%) liaisons participated in the study and revealed an overall lack of familiarity with the policies in place and inconsistencies in the resources offered to breastfeeding employees across the university system. Only half of the participating liaisons reported a formal breastfeeding policy was in place on their campus. From the document review, six major themes were identified: placing the burden on employees, describing pregnancy or postpartum as a "disability," having a university-specific policy, inclusion of break times for breastfeeding, supervisor responsibility, and information on lactation policies.
CONCLUSION
The review of each institution's online resources confirmed the survey findings and highlighted the burden placed on employees to discover the available resources and advocate for their needs. This paper provides insight into how institutions support breastfeeding employees and provides implications on strategies to develop policies at universities to improve breastfeeding access for working parents.
Topics: Humans; Breast Feeding; Female; Universities; Surveys and Questionnaires; Organizational Policy; Return to Work; Workplace; United States; Lactation; Patient Protection and Affordable Care Act; Adult
PubMed: 38750490
DOI: 10.1186/s12884-024-06541-9 -
BMC Women's Health May 2024To investigate the extent of knowledge about breastfeeding and attitudes towards infant feeding among spouses of puerperas at the time of discharge from hospital, and...
OBJECTIVE
To investigate the extent of knowledge about breastfeeding and attitudes towards infant feeding among spouses of puerperas at the time of discharge from hospital, and explore the factors influencing spousal attitudes toward breastfeeding.
METHODS
We conducted a questionnaire survey among 204 spouses of puerperas who were admitted in the maternity wards at a tertiary hospital in Shaanxi Province between October 2021 and December 2021. Respondents who fulfilled the inclusion criteria were identified using convenient sampling.
RESULTS
(1) The score of breastfeeding knowledge among spouses prior to discharge from the hospital was (10.56 ± 3.78), with an accuracy rate of 59.6%, and the lowest accuracy rate was for Item 1 "Newborns should be fed on time, not on demand" (42.6%) and Item 5 "Breastfeeding can prevent infant rickets" (49.5%). (2) The average score of spouses' infant feeding attitudes was (58.15 ± 5.55), and the lowest scoring was for Item 17 "Daily urine volume of infants is a reliable indicator to judge whether they get enough breast milk" (1.99 ± 1.14). (3) Generalized linear model analysis showed a more positive attitude (higher score) among spousal attitudes towards infant feeding in those who had received breastfeeding education [OR = 4.588, 95% CI (0.160 ∼ 3.598)] and those with a master's degree or above [OR = 18.278, 95% CI (3.471 ∼ 9.346)].
CONCLUSION
(1) Spouses that received breastfeeding education and those that had a Masters Degree and above had more positive attitude towards infant feeding. (2) Medical staff should focus on puerperas'spouses with degrees below master's level who had not received breastfeeding education. We recommend using a variety of education methods to enable them to acquire more knowledge on breastfeeding and develop a more positive attitude towards breastfeeding, which will further enhance spousal support for breastfeeding, thus positivizing postpartum co-parenting attitudes and improving the rate of exclusive breastfeeding.
Topics: Humans; Breast Feeding; Spouses; Female; Health Knowledge, Attitudes, Practice; Adult; Male; Surveys and Questionnaires; Postpartum Period; China; Infant, Newborn
PubMed: 38750465
DOI: 10.1186/s12905-024-03116-w -
PloS One 2024Susceptibility to morbidity and mortality is increased in early life, yet proactive measures, such as breastfeeding and weaning practices, can be taken through specific...
Susceptibility to morbidity and mortality is increased in early life, yet proactive measures, such as breastfeeding and weaning practices, can be taken through specific investments from parents and wider society. The extent to which such biosocialcultural investment was achieved within 1st millennium BCE Etruscan society, of whom little written sources are available, is unkown. This research investigates life histories in non-adults and adults from Pontecagnano (southern Italy, 730-580 BCE) in order to track cross-sectional and longitudinal breastfeeding and weaning patterns and to characterize the diet more broadly. Stable carbon and nitrogen isotope analysis of incrementally-sampled deciduous and permanent dentine (n = 15), bulk bone collagen (n = 38), and tooth enamel bioapatite (n = 21) reveal the diet was largely based on C3 staple crops with marginal contributions of animal protein. Millet was found to play a role for maternal diet and trajectories of breastfeeding and feeding for some infants and children at the site. The combination of multiple isotope systems and tissues demonstrates exclusive breastfeeding was pursued until 0.6 years, followed by progressive introduction of proteanocius supplementary foods during weaning that lasted between approximately 0.7 and 2.6 years. The combination of biochemical data with macroscopic skeletal lesions of infantile metabolic diseases and physiological stress markers showed high δ15Ndentine in the months prior to death consistent with the isotopic pattern of opposing covariance.
Topics: Humans; Italy; Infant; Diet; Carbon Isotopes; Nitrogen Isotopes; History, Ancient; Bone and Bones; Female; Paleopathology; Adult; Weaning; Breast Feeding; Stress, Physiological; Dentin; Collagen; Child, Preschool; Male; Child
PubMed: 38748638
DOI: 10.1371/journal.pone.0302334 -
Veterinary and Animal Science Jun 2024The aim of this experiment was to investigate the effects of peppermint essential oil (PEO) and an emulsifier called artifier on growth performance, carcass...
Effects of peppermint essential oil and artifier on growth performance, carcass characteristics and nutrient digestibilities in broiler chickens fed with low energy diets.
The aim of this experiment was to investigate the effects of peppermint essential oil (PEO) and an emulsifier called artifier on growth performance, carcass characteristics, and nutrient digestibility of broiler chickens fed low-energy diets. A total of 240 one-day-old male Ross 308 broiler chickens were divided into five treatments: control, low-energy diet, low-energy diet + 150 ppm PEO, low-energy diet + 300 ppm artifier, and low-energy diet + 150 ppm PEO + 300 ppm artifier. Each treatment was replicated four times in a completely randomized design. The chickens were fed these treatments during the starter, grower, and finisher periods for a total of 42 days. The results indicated that broiler chickens receiving the low-energy diet supplemented with PEO + artifier had similar body weight gain, feed conversion ratio, and breast percentage, but exhibited significantly lower abdominal fat percentage compared to those fed the control diet ( < 0.05). Furthermore, birds receiving PEO and artifier in low-energy diets, either individually or in combination, demonstrated higher digestibility of dry matter and fat during the starter and grower periods in comparison to those receiving the low-energy diet without any additives ( < 0.05). Over the entire rearing period, the simultaneous inclusion of 150 ppm PEO and 300 ppm artifier in the low-energy diet resulted in comparable growth performance to the control diet. Additionally, the concurrent use of PEO and artifier in the low-energy diet for broiler chickens led to a decrease in abdominal fat, increased digestibility of fat and dry matter, and enhanced nutrient utilization compared to the control diet.
PubMed: 38745888
DOI: 10.1016/j.vas.2024.100354 -
International Breastfeeding Journal May 2024Breastfeeding resets insulin resistance caused by pregnancy however, studies on the association between breastfeeding and diabetes mellitus (DM) have reported...
BACKGROUND
Breastfeeding resets insulin resistance caused by pregnancy however, studies on the association between breastfeeding and diabetes mellitus (DM) have reported inconsistent results. Therefore, we aimed to investigate the risk of DM according to breastfeeding duration in large-scale population-based retrospective study. In addition, machine-learning prediction models for DM and hemoglobin A1c (HbA1c) were developed to further evaluate this association.
METHODS
We used the Korean National Health and Nutrition Examination Surveys database, a nationwide and population-based health survey from 2010 to 2020. We included 15,946 postmenopausal women with a history of delivery, whom we divided into three groups according to the average breastfeeding duration: (1) no breastfeeding, (2) < 12 months breastfeeding, and (3) ≥ 12 months breastfeeding. Prediction models for DM and HbA1c were developed using an artificial neural network, decision tree, logistic regression, Naïve Bayes, random forest, and support vector machine.
RESULTS
In total, 2248 (14.1%) women had DM and 14,402 (90.3%) had a history of breastfeeding. The prevalence of DM was the lowest in the < 12 breastfeeding group (no breastfeeding vs. < 12 months breastfeeding vs. ≥ 12 months breastfeeding; 161 [10.4%] vs. 362 [9.0%] vs. 1,725 [16.7%], p < 0.001). HbA1c levels were also the lowest in the < 12 breastfeeding group (HbA1c: no breastfeeding vs. < 12 months breastfeeding vs. ≥ 12 months breastfeeding; 5.9% vs. 5.9% vs. 6.1%, respectively, p < 0.001). After adjustment for covariates, the risk of DM was significantly increased in both, the no breastfeeding (adjusted odds ratio [aOR] 1.29; 95% CI 1.29, 1.62]) and ≥ 12 months of breastfeeding groups (aOR 1.18; 95% CI 1.01, 1.37) compared to that in the < 12 months breastfeeding group. The accuracy and the area under the receiver-operating-characteristic curve of the DM prediction model were 0.93 and 0.95, respectively. The average breastfeeding duration was ranked among the top 15 determinants of DM, which supported the strong association between breastfeeding duration and DM. This association was also observed in a prediction model for HbA1c.
CONCLUSIONS
Women who did not breasted had a higher risk of developing DM than those who breastfed for up to 12 months.
Topics: Humans; Female; Breast Feeding; Retrospective Studies; Machine Learning; Middle Aged; Republic of Korea; Diabetes Mellitus; Glycated Hemoglobin; Time Factors; Aged; Menopause; Nutrition Surveys; Prevalence
PubMed: 38745339
DOI: 10.1186/s13006-024-00642-z