National infant and young child feeding policy

The document looks at the National infant and young child feeding policy It states the importance of Optimal Feeding Practices; challenges; current interventions; implementation monitoring and evaluation. It contains information on exclusive breastfeeding, complementary feeding at 6 months and older, Baby-friendly Hospital Initiative, Global Policy Agenda; institutional framework. It also looks at the Public Health Act (1974); Early Childhood Act (20050 and the Maternity Leave Act of Jamaica (1979)

Breastfeeding support at work: A comparison between career women in the public and private sectors in Trinidad and Tobago

OBJECTIVE: To evaluate knowledge and perceptions toward breastfeeding support at work among women in public and private sectors in Trinidad and Tobago. SUBJECTS AND METHODS: A purposive sampling design was used to select women employees from the public and private sectors. Employees were surveyed using a self administered 16-item structured questionnaire. Data were analysed using SPSS version 21. Independent t-test wasused to compare perceptions held by the public and private sectors. Pearson’s correlation was used to determine the relationship between the variables. The level of significance was set at the 0.05 level. RESULTS: The mean breastfeeding knowledge score for the participants was 2.31 ± 0.83, with the public sector employees having a mean score of 2.42 ± 0.759, which was statistically significant (p = 0.004) when compared to the private score of 2.14 ± 0.914. The mean readiness score 26to utilize breastfeeding support for the public and private sectors employees were 1.08 ± 0.482 and 1.14 ± 0.525, respectively; however, no significant difference was observed between the two groups (p = 0.294). The mean perception scores were 1.75 ± 0.985 for the public sector and 1.90 ± 0.950 for the private sector, with no significant difference between groups (p = 0.184). CONCLUSIONS: Participants had adequate breastfeeding knowledge and a positive attitude and perception toward breastfeeding at work. We recommend that an intervention programme be developed to increase the awareness of breastfeeding support at work so that employees and employers can become more aware of its purpose and benefits.

Maternal infant feeding styles and the risk for overweight in Caribbean infants

OBJECTIVE: To examine the role of maternal feeding styles on the risk of overweight in a cohort of Caribbean infants. DESIGN AND METHODS: Data from mother-child pairs participating in an intervention study from 3 Caribbean islands were analysed. At recruitment, maternal and infant socio demographic and anthropometric data were collected and maternal depression assessed usingthe Center for Epidemiology Studies (CES) depression scale questionnaire. At 12 months, feeding styles was assessed in mothers by questionnaire. Factor analysis yielded five feeding styles: uninvolved, indulgent, forceful, restrictive and responsive. Infant length and weight were measured using standardized protocols at 18 months and BMI Z-scores were calculated from World Health Organization 2006 growth charts. Z-scores ≥ 1 were classified as at risk for overweight. Associations between maternal feeding styles and risk for infant overweight were assessed using multilevel logistic regression accounting for country and clinic. RESULTS: Data from 366 mother-child pairs (mean age 26.08ñ7.05 years, 55.5% high school graduates, 67.5% employed) were evaluated. No association was found between uninvolved, indulgent, forceful and responsive feeding styles with risk for infant overweight. Restrictive feeding was associated with increased risk for infant overweight (β=0.46; 95%CI=0.21,0.72) and the association remained after adjustment for infant birth weight, maternal age, education, socio-economic status and BMI (β=0.48;95%CI=0.21,0.74). This associationstrengthened after adjusting for maternal depression (β=0.55;95%CI=0.27,0.82). CONCLUSION: Restrictive feeding increased the risk of infant overweight. Overweight/obesity prevention interventions focusing on identifying suitable maternal feeding control as well as larger studies aimed at understanding the underlying mechanisms for this association are important approaches to tackling childhood overweight.

Early termination of breast-feeding in periurban Santo Domingo, Dominican Republic: mothers' community perceptions and personal practices

The objectives of this study were to determine: 1) whether mothers' perceptions of typical community practice for breast-feeding duration influence their personal practices and 2) whether the mothers' reports of community reasons for terminating breast-feeding identify barriers not elicited through self-report. The study was conducted in 1997 in a sample of poor neighborhoods in a periurban district of Santo Domingo, the capital of the Dominican Republic. A representative sample of 220 mothers from these neighborhoods was interviewed with a structured questionnaire. While the duration of the brest-feeding was similar for self-report and for mothers' perceptions of typical community practice, there was no statistically significant correlation between these two variables. "Mother-driven" reasons for early termination of breast-feeding, such as "fear of loss of figure or breast shape" and " not wanting to breast-feed" were frequently perceived as community reasons but rarely given as personal reasons. Personal reasons were predominantly "child-driven," including " the child not wanting the breast," or reasons beyond the mothers' control such as having "insufficient" milk. Maternal report of community reasons for early termination may be a useful way to identify factors that would not otherwise be revealed on self-report. These additional reasons may guide health promotion efforts aimed at increasing breast-feeding duration (AU)

Factors relating to exclusive breast feeding among mothers attending post natal clinic (PNC) and well baby clinic (WBC) at The University Hospital of the West Indies, Jamaica

The benefits of breast feeding for mother and child have been long established. This study was undertaken to determine the prevalence of breast feeding among mothers at selected clinics at the University Hospital of the West Indies and the barriers relating to exclusive breast feeding. Additionally the study sought to determine the knowledge, attitudes, perceptions and practices of the mothers with respect to breast feeding. A convenient sample of 120 mothers was selected from the Postnatal and Well Baby Clinics at the hospital. The mothers were interviewed using a structured questionnaire. A focus group interview was conducted with selected mothers. Results showed that the prevalence of breast feeding was 67.2 percent with exclusive breast feeding being 22.7 percent. Respondents who were not currently breast feeding were significantly more likely to give their baby water. Aproximatley 38 percent of respondents did not know how long breast feeding should last for. The majority of respondents (83.3 percent) indicated that breast milk was the first feed given to their baby. Approximately 23 percent of mothers had problems with breast feeding and 63 percent of those who experienced problems with breast feeding were first mothers. Seventy seven percent (77 percent) of mothers introduced supplementary feeds into the infant's diet and those who introduced supplementary feeds were significantly less likely to breast feed. Approximately 46.6 percent disagreed or strongly disagreed that breast milk alone can satisfy a 3-month old baby. There is need for mothers and other family members to be educated more about the benefits of breast feeding and the University Hospital of the West Indies should endeavour to fully implement the Baby Friendly Hospital Initiative (AU)

Guidelines for young children feeding in the Caribbean - part II

This is the second of a three-part series by the Caribbean Food and Nutrition Institute (CFNI) on revised guidelines for young children feeding in the Caribbean. In Part I, the guidelines dealt with the period before birth. These covered maternal nutrition and guidelines for promoting, protecting and supporting breastfeeding. This part covers the broad area of breastfeeding, nutrition of the newborn with low birthweight or other special requirements, and replacement feeding for infants who are not breastfed. It also discusses the introduction of complementary foods with emphasis on the continuation of breastfeeding for two years and beyond.(AU)

Knowledge, beliefs and practices of breastfeeding among adults in Tobago East: preliminary findings - Poster abstract

OBJECTIVES: To evaluate the knowledge, beliefs and practices of breastfeeding among adults in Tobago East. DESIGN AND METHODS: A cross-sectional survey was conducted on adults aged > 18 years residing in Tobago East. All participants were interviewed using structured questionnaires. RESULTS: The study comprised 509 persons of who 312 (61 percent) were females. Ninety-five percent (95 percent), 69 percent and 48 percent of the respondents indicated that a baby should be exclusively breastfed at birth, 3 months and 6 months, respectively. The main source of information about breastfeeding was obtained from the health center (53 percent). The mother (50 percent) and both parents (29 percent) were thought to be responsible for making the decision to breastfeed. Sixty-three percent (63 percent) and 80 percent of the respondents did not know about "expressed breast milk and cup-feeding' of a new-born while 82 percent and 47 percent believed that the breastfed baby should be given water and that breastfeeding caused a woman's breast to sag. In addition, 23 percent and 44 percent felt that breastfeeding should be terminated <6 months of age and between 6 and 12 months, respectively. The respondents believed that inadequate maternal nutrition (35 percent) and maternal employment (26 percent) were the principal factors affecting breastfeeding. CONCLUSION: There is a low level of awareness among the respondents regarding the value of exclusive breastfeeding for the first six months. These findings can be used to guide the development and implementation of interventions to promote exclusive breastfeeding in Tobago.(AU)

Guidelines for young child feeding in the Caribbean - Part I

The guidelines for young child feeding have been developed and prepared as a supportive-tool primarily for health personnel involved in the care of infants and children in Caribbean countries. The recommendations address some practical aspects of nutrition before, during and after pregnancy. These are: The benefits of breastfeeding and strategies for its promotion, protection and support; review of infant feeding options for mothers with HIV and other infections; nutrition of the newborn; feeding of low birth weight infants and those with special requirements; replacement feeding for infants who are not breastfed; complementary feeding with emphasis on the continuation of breastfeeding for two years and beyond; guidelines on vitamin and mineral supplementation; management of feeding-related problems in early childhood; policy issues and nutrition education in relation to the promotion of adequate nutrition in early childhood.(Au)

Breast-feeding and weight change in newborns in Jamaica

This study was conducted to examine weight change of breast-fed infants during the first week and through the first 24 days of life, and to evaluate the effect of breast-feeding factors and maternal characteristics on early weight change in infants. The weights of 21 infants were recorded on day 1 (day of birth), and on days 3, 7, 10, 17, and 24, and the data analysed to evaluate weight change over the period. Multiple regression analysis was used to assess whether birth weight as well as maternal and breast-feeding factors were significant predictors of weight on day 24. Nineteen of the 21 infants gained weight between days 1 and 3, and 20 infants gained weight between days 3 and 7. All infants gained weight over the 24-day period and their weights at day 7 and day 24 were significantly different (P <0.05 and P <0.01, respectively) from their birth weights. Multiple linear regression analysis showed that significant (P < 0.01) predictors of weight gain by day 24 included birth weight, mother's educational level, whether the baby cried before feeding, and length of feeding time periods. This is the first study of weight change in the early days and weeks of life of exclusively breast-fed newborn infants in Jamaica. The infants showed significant weight gain during the study period and weight gain was affected by certain maternal and breast-feeding factors. (AU)

Factors relating to exclusive breast feeding among mothers attending post natal clinic (PNC) and well baby clinic (WBC) at the University Hospital of the West Indies, Jamaica

The benefits of breast feeding for mother and child have been long established. This study was undertaken to determine the prevalence of breast feeding among mothers at selected clinics at the University Hospital of the West Indies and the barriers relating to exclusive breast feeding. Additionally the study sought to determine the knowledge, attitudes, perceptions and practices of the mothers with respect to breast feeding. A convenient sample of 120 mothers was selected from the Postnatal and Well Baby Clinics at the hospital. The mothers were interviewed using a structured questionnaire. A focus group interview was conducted with selected mothers. Results showed that the prevalence of breast feeding was 67.2 percent with exclusive breast feeding being 22.7 percent. Respondents who were not currently breast feeding were significantly more likely to give their baby water. Approximately 38 percent of respondents did not know how long breast feeding should last for. The majority of respondents (83.3 percent) indicated that breast milk was the first feed given to their baby. Approximately 23 percent of mothers had problems with breast feeding and 63 percent of those who experienced problems with breast feeding were first mothers. Seventy seven percent (77 percent) of mothers introduced supplementary feeds into the infant's diet and those who introduced supplementary feeds were significantly less likely to breast feed. Approximately 46.6 percent disagreed or strongly disagreed that breast milk alone can satisfy a 3-month old baby. There is need for mothers and other family members to be educated more about the benefits of breast feeding and the University Hospital of the West Indies should endeavour to fully implement the Baby Friendly Hospital Initiative.(Au)

Estimating the time of HTLV-I infection following mother-to-child transmission in a breast-feeding population in Jamaica

Mother-to-child transmission of human T-cell lymphotrophic virus type 1 (HTLV-I) is primarily due to prolonged breast-feeding (>6 months) in the post-natal period. Most infant infections are not identifiable until 12-18 months of age by available whole virus Western blot serologic tests because of their inability to distinguish passively transferred maternal antibody from infant antibody. We investigated two methods to assess more accurately the time of infant infection. In prospectively collected serial biospecimens, HTLV-I-specific immunoglobulin (Ig) isotypes of IgM and IgA were determined by Western blot and HTLV-I proviral DNA was detected by polymerase chain reaction (PCR). IgA and IgG reactivity was assessed in periodic serum samples from 16 HTLV-I-seropositive children while IgM reactivity was observed in 100 percent of children at 24 months of age and 73 percent of children at 6-12 months of age; however, this could represent maternal and not infant antibody. Both IgA and IgM reactivity were insensitive indicators of infection, with only 50 percent of children showing reactivity at 24 months of age. PCR testing was performed in biospecimens obtained from 11 of these children. An estimated median time of infection of 11.9 months was determined by PCR, which was similar to the median time to infection determined by whole virus Western blot (12.4 months; P=0.72). PCR Tests support a median time to infection that is similar to that estimated by whole virus Western blot. (AU)

Maternal moods predict breast-feeding in Barbados

This study was designed to identify psychosocial variables affecting early infant feeding practices in Barbados. The sample included 93 healthy women and infants born at the Queen Elizabeth Hospital who were extensively evaluated 7 weeks, 3 months, and 6 months after birth. Maternal moods were assessed with the Zung Depression and Anxiety Scales and the General Adjustment and Morale Scale. Feeding practices were evaluated using a questionnaire developed for this population. The prevalence of mild depression in this population was 16 percent at 7 weeks and increased to 19 percent at 6 months, whereas there were very few cases of moderate-to-severe depression. Disadvantaged environmental conditions, including less information-seeking by the mother, lower family income, and poor maternal health, were closely associated with increased symptoms of depression and anxiety in all women. However, significant predictive relationships between mood and feeding practices remained even when the effects of the home environment were controlled. Specifically, depressive symptoms at 7 weeks postpartum predicted a reduced preference for breastfeeding at current and later infant ages. Conversely, feeding practices did not predict maternal moods at later ages. These findings have important implications for public policy dealing with programs promoting breastfeeding. Early interventions designed to treat mild postnatal depression should be instituted early in the postpartum period to improve the chances for successful breastfeeding.(Au)

Prevalence and determinants of breast-feeding among mothers of infants two-three months old attending child health clinics at two health centres in Kingston and St. Andrew and two in St. Ann, Jamaica

The prevalence of exclusive breast-feeding has remained below targets established by the Ministry of Health of Jamaica. This cross-sectional study examined the prevalence and determinants of breast feeding among mothers of infants two to three months of age attending child health clinics at two health centres in Kingston and St. Andrew and two in St. Ann. A total of 95 mothers were interviewed using a structured questionnaire. Two focus grop discussion were also conducted. Data from the questionnaire were analyzed in Epi-info version 6.03. The pevalence of breast-feeding was found to be high (90.5 percent) while that of exclusive breast-feeding was low (8.4 percent). Younger women were less likely to breast-feed exclusively. There was no significant association between parity, employment or marital status and exclusive breast-feeding. Among the other factors examined, failure to get help to solve breast-feeding problems was the only one found to be significantly associated with cessation of breast-feeding (Fisher's exact test, two tailed p=0.0095). The role of education, and various types of support for mothers, were idenfified among factors which would facilitate exclusive breast-feeding for at least four months. Further studies are required to determine the relationship between employment status of mothers and exclusive breast-feeding. Education programmes should aim to improve attitudes of mothers, should target young mothers and play keen attention to changes in the socio-economic environment (AU)

Prevalence and determinants of breast-feeding among mothers of infants two-three months old attending child health clinics at two health centres in Kingston and St. Andrew and two in St. Ann, Jamaica

The prevalence of exclusive breast-feeding has remained below targets established by the Ministry of Health of Jamaica. This cross-sectional study examined the prevalence and determinants of breast feeding among mothers of infants two or three months of age attending child health clinics at two health centres in Kingston and St. Andrew and two in St. Ann. A total of 95 mothers were interviewed using a structured questionnaire. Two focus group discussions were also conducted. Data from the questionnaire were analyzed in Epi-info version 6.03. The prevalence of breast-feeding was found to be high (90.5 percent) while that of exclusive breast-feeding was low (8.4 percent). Younger women were less likely to breast-feed exclusively. There was no significant association between parity, employment or marital status and exclusive breast-feeding.(AU)

Mother-to-child transmission of human T-cell lymphotropic virus type I associated with prolonged breast-feeding

OBJECTIVES: We assessed the risk of transmitting human T-cell lymphotropic virus type I (HTLV-I) through breastfeeding. STUDY DESIGN/METHODS: To assess the risk of mother-to-child transmission of HTLV-I, 212 HTLV-I-seropositive women and 145 HTLV-I-seronegative women were enrolled in a prospective cohort study conducted in Kingston, Jamaica. Their offspring were examined at regular intervals, and HTLV-I serostatus was determined at each visit. RESULTS: Twenty-eight of the 181 children with at least one postnatal visit born to HTLV-I-seropositive women and (none of the children born to HTLV-I-seronegative women) were persistently seropositive, compared with only 8 (9 percent) of 86 children breast-fed for less than 12 months (relative risk, 3.4; 95 percent CI, 1.7 - 6.9). Compared with children weaned at younger ages, transmission of HTLV-I was associated with continued breast-feeding of children who were 12 to 18 months of age (relative hazard, 6.4; 95 percent CI. 2.1 - 180.2) and older than 18 months (relative hazard, 18.1; 95 percent, 1.4 - 29.5). Transmission was also associated with higher maternal antibody titer (a possible marker of virus load), prolonged duration of ruptured membranes during childbirth, and lower maternal income. CONCLUSIONS: These results suggest that limiting the duration of breast-feeding to less than 12 months for children born to HTLV-I-seropositive mothers may significantly reduce mother-to-child transmission of HTLV-I.(Au)

A visit to Trinidad and Tobago

Trinidad and Tobago are the two southerly of the Caribbean islands off the coast of Venezuela. Trinidad is industrial, having natural deposits of oil, gas and bitumen, while Tobago is a tropical holiday island, sometimes known as Robinson Crusoe Island. The population of 1.3 million represents races from Africa, India, Europe and Asia, who live and work together harmoniously; Trinidadian women are renowned for their beauty, resulting from this rich mix. The centre of Trinidad is heavily forested and-apart from the capital, Port-of-Spain the towns are small and rural in character. Fruits grows abundantly, especially mangoes, bananas, pineapples, citrus fruits, paw-paw and coconuts.(AU)