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1.
Med. infant ; 26(4): 346-350, dic. 2019. ilus, Tab
Artigo em Espanhol | LILACS | ID: biblio-1047043

RESUMO

Introducción: La incorporación de las mujeres a la fuerza laboral, así como las contradicciones existentes entre las recomendaciones de salud y el marco legal que ampara a las madres trabajadoras, hacen que no se logre cumplir las recomendaciones de la Organización Mundial de la Salud (OMS) sobre la práctica de la lactancia materna exclusiva durante seis meses y el mantenimiento hasta los dos años o más, y la introducción de alimentos apropiados para la edad y seguros desde los seis meses. Objetivo: Conocer las características demográficas de la población de estudio; la percepción de las madres sobre las barreras y facilitadores de la LM durante la jornada laboral en el hospital y elaborar estrategias que permitan facilitar la LM a los niños menores de tres años cuyas madres trabajen en el hospital. Material y métodos: estudio transversal, participaron de la investigación las mujeres que trabajaron en el Hospital Garrahan durante los meses de julio 2017 a marzo 2018, cuyos hijos de 0 a 3 años asistieron al jardín maternal del hospital. Resultados: de los 162 niños, hijos de las trabajadoras, que participaron de la investigación, 79 recibieron LM al momento de la encuesta (48,8%). El 53% de los niños menores de 6 meses recibieron lactancia materna exclusiva; el 65% de los niños de 6 a 12 meses y el 24% de los niños de 1 a 3 años recibieron lactancia materna continuada. Además, la mitad de las madres encuestadas manifestaron haber tenido problemas en relación a la LM. Conclusión: Se esperaba contar con mejores índices de lactancia materna dada la población estudiada, ya que la mayoría son mujeres profesionales y que han recibido educación en LM. Se elaboraron estrategias para mejorar los índices de lactancia en el hospital.(AU)


Introduction: The incorporation of women in the workforce as well as the current contradictions among health recommendations and the legal framework that protects working mothers lead to difficulties to meet the recommendations of the World Health Organization (WHO) on exclusive breastfeeding practices during the first six months of life and maintenance up to two years or more, and the introduction of adequate and safe food according to age after six months. Objective: To identify the demographic features of the study population; the perception of mothers about the barriers and facilitators of breastfeeding during the working day at the hospital and to develop strategies to facilitate breastfeeding for children younger than three years whose mothers work at the hospital. Material and methods: A cross-sectional study evaluating mothers who worked at Garrahan Hospital between July 2017 and March 2018, with children between 0 and 3 years of life who attended the day care center of the hospital. Results: of 162 children of wokers of the hospital that participated in the study, 79 were breastfed during the study period (48.8%). Overall, 53% of the infants younger than 6 months of life were exclusively breatsfed; 65% of the children between 6 and 12 months, and 24% of the children aged between 1 and 3 years received additional breastfeeding. Half of the mothers that were surveyed manifested having problems with breastfeeding. Conclusion: Higher rates of breastfeeding were expected in the study population as the majority of the women were professionals who had information on maternal breastfeeding. Strategies will be developed to improve the breastfeeding rate at the hospital (AU)


Assuntos
Humanos , Recém-Nascido , Lactente , Pré-Escolar , Escolas Maternais , Mulheres Trabalhadoras/legislação & jurisprudência , Aleitamento Materno/estatística & dados numéricos , Estudos Transversais , Inquéritos e Questionários
2.
Pan Afr Med J ; 34: 47, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31762913

RESUMO

Introduction: Despite the fact that mothers know the exact age to wean their infants, majority of the mothers do not practice exclusive breastfeeding due to cultural beliefs and practices. The purpose of the study was to explore cultural beliefs and practices associated with weaning children at the Maternal Child Health Clinic Kalisizo Hospital. Methods: This was a simple qualitative study. Seven in-depth-interviews were conducted among 7 mothers of children within the ages 0-12 months attending post-natal care services using self-generated semi-structured key informant's guide. This took place at the Maternal Child Health Clinic Kalisizo Hospital. Purposive sampling method was used to select mothers for the study. Three themes were generated namely: identification of the different cultural beliefs and practices associated with weaning, how the different cultural beliefs are practiced and the impacts of these cultural beliefs and practices. Data were analysed using thematic analysis. Results: Although a majority of the mothers knew the recommended age to wean their infants, they did not ignore the ill-informed cultural beliefs, taboos and practices from their elders such as peer pressure, advice and counselling from mother-in laws and teachings from older women who are seen as role models. Conclusion: Adherence to cultural beliefs, taboos and practices, have a powerful influence on weaning, hence hindering exclusive breast feeding.


Assuntos
Aleitamento Materno/estatística & dados numéricos , Conhecimentos, Atitudes e Prática em Saúde , Mães/estatística & dados numéricos , Desmame/etnologia , Adolescente , Adulto , Aleitamento Materno/etnologia , Feminino , Humanos , Lactente , Recém-Nascido , Entrevistas como Assunto , Centros de Saúde Materno-Infantil , Pesquisa Qualitativa , Uganda , Adulto Jovem
3.
Medicine (Baltimore) ; 98(47): e17822, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31764775

RESUMO

BACKGROUND: Despite breastfeeding is significant benefits for maternal and infant, the discontinuation of breastfeeding is high. Some of studies showed that the effect of intervention in improving the rate of exclusively breastfeeding is unclear. The aim of this study is to investigate the effectiveness of individualized intervention compared with routine care in improving rates of exclusive breast feeding. METHODS: Women were divided into two groups. We provided individual antenatal breastfeeding education and postnatal lactation support to intervention group. Control group received routine care. Significance was set at P < .05. RESULTS: We recruited 352 women of whom 176 were randomized to intervention group, 176 to control group. In total, 293 (83.2%) completed 4 months of follow-up. At discharge from hospital, 43.2% of women randomized to intervention group were exclusively breastfeeding compared with 30.0% of women in control group (relative risk 1.78; 95% confidence interval [CI] 1.12-2.82). At 4 months, 70.9% of women in the intervention group were exclusively breastfeeding compared with 46.2% of the women in the control group (2.84; 1.76-4.60). At discharge from hospital, 95.1% of women in the intervention group were breastfeeding on demand compared with 68.1% of women receiving routine care (9.00; 4.09-19.74). At 4 months, 94.6% of women in intervention group were breastfeeding on demand compared with 75.9% of women in the control group (5.57; 2.48-12.49). CONCLUSION: The regular ongoing individualized antenatal education and postnatal support can effective increase the rates of exclusive breastfeeding from delivery to postpartum 4 months and change the breastfeeding behavior.


Assuntos
Aleitamento Materno/estatística & dados numéricos , Cuidado Pós-Natal , Educação Pré-Natal , Adulto , Feminino , Promoção da Saúde , Humanos , Método Simples-Cego
4.
Medicine (Baltimore) ; 98(44): e17737, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31689820

RESUMO

The World Health Organization and United Nations Children's Fund's Baby-Friendly Hospital Initiative is aimed at the global promotion, protection and support of breastfeeding. In this study, we compared breastfeeding-related information received, knowledge and behaviours among postpartum women in Baby-Friendly Hospital Initiative accredited and non-accredited hospitals. We selected 10 hospitals: 9 non-accredited hospitals in the Campania region in southern Italy and one accredited hospital in the Piedmont region in northern Italy. In total, 786 women (580 (73.8%) in Campania and 206 (26.2%) in Piedmont) in the hospitals' maternity wards completed a questionnaire comprising 5 sections within 24 to 72hours after giving birth. The questionnaire investigated breastfeeding activities in the days immediately following childbirth, as well as the information provided by health personnel, knowledge about breastfeeding before and during hospitalisation, and participation in antenatal classes. To evaluate the comparison between the 2 regions, we performed at first a bivariate analysis and then a multinomial and a multivariate logistic regression. Compared with Piedmont, in Campania hospitals there was a rate of breastfeeding of 44.3% vs 89.3%, a skin-to-skin contact between mother and child of 74.5% vs 90.7% and first milk feed within 2hours of 15.0% vs 87.2%. The Campania group had fewer problems with child latching. The Campania group reported receiving less information about breastfeeding in general compared with the Piedmont group. In general, both groups showed good basic knowledge about different aspects of breastfeeding. In both regions, about 90% reported that the information received during the antenatal classes simplified the breastfeeding experience. Our study confirms the importance of systematic promotion of breastfeeding and subsequent delivery of adequate support to maternity departments, in accordance with international guidelines.


Assuntos
Aleitamento Materno/estatística & dados numéricos , Fidelidade a Diretrizes/estatística & dados numéricos , Promoção da Saúde/normas , Mães/estatística & dados numéricos , Unidade Hospitalar de Ginecologia e Obstetrícia/estatística & dados numéricos , Adulto , Aleitamento Materno/psicologia , Estudos Transversais , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Promoção da Saúde/métodos , Humanos , Recém-Nascido , Itália , Modelos Logísticos , Mães/psicologia , Análise Multivariada , Unidade Hospitalar de Ginecologia e Obstetrícia/normas , Gravidez , Avaliação de Programas e Projetos de Saúde , Nações Unidas , Organização Mundial da Saúde
5.
Sante Publique ; Vol. 31(3): 451-458, 2019.
Artigo em Francês | MEDLINE | ID: mdl-31640333

RESUMO

INTRODUCTION: The study had for object to identify factors associated to the cessation of the exclusive breast-feeding at the mothers of children from 0 to 6 months in the urban and rural circles in Mali. METHOD: The study was longitudinal forward-looking, realized in Bamako (urban area) and in Dialakoroba (rural area) from April till November, 2016. in total, 218 mothers were enlisted (114 by area) in a voluntary way in health centers. A monthly follow-up of six months was realized in the place of residence. The SPSS 20 software was used for the seizure and the data analysis. The expected event was to give to the child another food than maternal milk. Test statistics such as Chi2 of Log Rank and Hazard Ratio (HR) were used with threshold of meaning p ≤ 0,05. RESULTS: In urban zones and rural respectively 68,5 % and 71,5% of the mothers had stopped the Exclusive Breast-feeding (EBF) before six months. Factors associated to this cessation of the EBF were: the use of the feeding-bottle (HR=2,61; IC 95%: [1,46-4,48]), the care of the child during less than three months as main occupation (HR=3,18; IC 95%: [1,95-5,20]), the support for the mother during less than three months (HR=3,79; IC 95%: [2,31-6,22]), the advice(council) on the EBF (HR=0,64; IC 95%: [0,46-0,98]) and the experience (experiment) of breastfeeding (HR=0,34; IC 95%: [0,15-0,84]). CONCLUSION: The consideration of the identified factors(mailmen) will allow to improve the practice of the EBF in six months in the sites of the study.


Assuntos
Aleitamento Materno/estatística & dados numéricos , Mães/psicologia , População Rural/estatística & dados numéricos , População Urbana/estatística & dados numéricos , Feminino , Seguimentos , Humanos , Lactente , Recém-Nascido , Mali , Mães/estatística & dados numéricos
6.
Epidemiol Health ; 41: e2019036, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31606979

RESUMO

OBJECTIVES: The study was to conduct a comparative assessment of drinking behaviors and overall health among pregnant and breastfeeding women. METHODS: This study used data collected from the Korean Community Health Survey in 2015. Data obtained from 2,156 pregnant or breastfeeding women were analyzed using descriptive statistics, the t-test, the chi-square test, and the Pearson correlation coefficient. RESULTS: Current drinking and alcohol consumption were higher among pregnant women than among breastfeeding women. Depression was twice as common among breastfeeding women than among pregnant women, and stress was much higher among breastfeeding women as well. Breastfeeding women also had lower subjective dental health and more unmet medical needs than pregnant women. CONCLUSIONS: Although pregnant women were in better overall health than breastfeeding women, many of them were unable to stop drinking, which is a risky and adverse health behavior that negatively affects maternal and fetal health. In order to reduce drinking among pregnant and breastfeeding women, it is necessary to develop a tailored, standardized educational program and national guidelines.


Assuntos
Consumo de Bebidas Alcoólicas/psicologia , Aleitamento Materno/estatística & dados numéricos , Nível de Saúde , Gestantes/psicologia , Adulto , Feminino , Inquéritos Epidemiológicos , Humanos , Gravidez , República da Coreia
7.
Artigo em Inglês | MEDLINE | ID: mdl-31533243

RESUMO

Delaying motherhood is becoming increasingly common, raising questions of the possible influence that maternal age may have on newborn health. Therefore, the objective of this study was to determine the association between maternal age and different newborn health parameters. An observational study was conducted in Spain on primiparous women and their infants. Data were collected on newborn health variables, breastfeeding, and different clinical practices that are beneficial for child health and development. Crude and adjusted mean differences were calculated along with the standard error of the mean. A total of 373 women and their children participated. In terms of early commencement skin-to-skin contact, the mean age of women that did skin-to-skin contact was 29.95 ± 0.31 years compared to 31.49 ± 0.66 years in those that did not (p = 0.042). In terms of other newborn parameters, such as preterm birth, health problems or complications, or the need for hospital admission, these were more frequent in the oldest group of mothers, but the differences found were not significant (p > 0.05). Hence, indicators of newborn morbidity were not found to be significantly associated with maternal age; however, beneficial practices such as early commencement skin-to-skin contact were found to be significantly associated with maternal age.


Assuntos
Saúde do Lactente/estatística & dados numéricos , Idade Materna , Mães/estatística & dados numéricos , Adulto , Fatores Etários , Aleitamento Materno/estatística & dados numéricos , Feminino , Humanos , Recém-Nascido , Avaliação Nutricional , Estado Nutricional , Gravidez , Espanha , Adulto Jovem
8.
Zhonghua Yu Fang Yi Xue Za Zhi ; 53(9): 913-918, 2019 Sep 06.
Artigo em Chinês | MEDLINE | ID: mdl-31474073

RESUMO

Objective: To analyze the correlation between elective cesarean delivery and duration of breastfeeding in Ma'anshan city from 2013 to 2014. Methods: From May 2013 to September 2014, a total of 3 474 pregnant women with the first prenatal checkup were recruited from Ma'anshan maternal and child health care hospital. Finally, 3 109 pregnant women were included after exclusion of those with terminated pregnancies, adverse birth outcomes, twin or multiple pregnancies, breech traction, breech midwifery and loss of delivery information. Demographic data of pregnant women, mode of delivery and breast feeding of children were collected through questionnaires and hospital records. Logistic regression model was used to analyze the relationship between elective cesarean delivery and duration of breastfeeding in children, with the mode of delivery as independent variable and the duration of breastfeeding as dependent variable. Results: The age of 3 109 subjects was (26.6±3.6) years old, the rate of vaginal delivery was 51.1% (1 589), and the rate of elective cesarean delivery was 46.4% (1 443), among which the rate of non-indicative elective cesarean delivery was 26.4% (820), the rate of indicative elective cesarean delivery was 20.0% (623), and the rate of emergency cesarean delivery was 2.5% (77). The proportion of breastfeeding lasting until 4, 12 and 18 months was 45.0% (1 348/2 998), 23.7% (702/2 962) and 5.2% (154/2 944), respectively. After adjusting the confounding factors, compared with vaginal delivery, the OR (95%CI) values of breastfeeding for 4 months in indicative elective cesarean delivery and non-indicative elective cesarean delivery women were 0.870(0.714-1.059), 0.795(0.665-0.949), and the OR (95%CI) values of breastfeeding for 12 months were 0.772(0.611-0.975), 0.755(0.610-0.934), respectively. Conclusion: Elective cesarean delivery may result in shorter duration of breastfeeding in children.


Assuntos
Aleitamento Materno , Cesárea , Adulto , Aleitamento Materno/estatística & dados numéricos , Cesárea/estatística & dados numéricos , Criança , China , Parto Obstétrico/estatística & dados numéricos , Feminino , Humanos , Gravidez , Gestantes , Fatores de Tempo , Adulto Jovem
9.
BMC Womens Health ; 19(1): 110, 2019 08 13.
Artigo em Inglês | MEDLINE | ID: mdl-31409345

RESUMO

BACKGROUND: Postmenopausal osteoporosis (PMOP) has long been a pervasive public health concern. With the aging Chinese population, the prevention, assessment and management of postmenopausal osteoporosis were particularly important. During the breastfeeding, a large amount of Calcium loss from maternal bone for infants' growth. However, whether this loss is completely reversible remains controversial. As the relationship between breastfeeding and postmenopausal osteoporosis is different from society to society and is not clear from the literature, the purpose of this study was to determine whether breastfeeding was an independent factor for the development of PMOP based on Chinese postmenopausal population. METHODS: A retrospective cross-sectional investigation was conducted at Tianjin Xiaobailou health Community Healthcare Center between December 2017 and June 2018. Postmenopausal women over the age of 50 who underwent the annual health examination or visited the center to perform bone densitometry as a part of routine screening for disease were recruited. A trained community nurse administered a questionnaire to all participants by face-to-face interview. Participants were questioned about age, BMI, Vitamin D and calcium intake, the history of smoking, drinking and fracture, age of menarche, age of menopause, the number of pregnancy, parity, feeding pattern (breastfeeding, artificial feeding and mixed feeding) and overall breastfeeding duration. BMD measurements were carried out using quantitative ultrasound (QUS) at the bilateral radius. RESULTS: A total of 202 women who met the inclusive and exclusive criteria were enrolled. Univariate analysis revealed that overall breastfeeding more than 24 months increased the risk of osteoporosis (OR 39.00, 95%CI 2.40-634.65, p = 0.010). However, multivariate estimate of the risk of osteoporosis by overall breastfeeding duration suggested that when controlling for age, BMI, the number of pregnancy and parity, the overall breastfeeding duration was not an independent risk factor for postmenopausal osteoporosis (OR 5.22, 95%CI 0.18-147.76, p = 0.333). Additionally, age (OR 1.16, 95%CI 1.05-1.29, p = 0.003), BMI (OR 1.26, 95%CI 1.04-1.54, p = 0.021) and the number of pregnancy (OR 1.80, 95%CI 1.08-2.98, p = 0.024) were significant associated with postmenopausal osteoporosis. CONCLUSION: Breastfeeding was not associated with postmenopausal osteoporosis, while age, BMI and the number of pregnancy may contribute to increasing risk of postmenopausal osteoporosis in Chinese women.


Assuntos
Aleitamento Materno/estatística & dados numéricos , Osteoporose Pós-Menopausa/epidemiologia , Fatores Etários , Idoso , Índice de Massa Corporal , China/epidemiologia , Estudos Transversais , Feminino , Número de Gestações , Humanos , Pessoa de Meia-Idade , Osteoporose Pós-Menopausa/diagnóstico , Estudos Retrospectivos , Fatores de Risco , Fatores de Tempo
10.
BMC Pregnancy Childbirth ; 19(1): 284, 2019 Aug 08.
Artigo em Inglês | MEDLINE | ID: mdl-31395024

RESUMO

BACKGROUND: Male partner antenatal clinic (ANC) attendance may improve maternal uptake of maternal child health (MCH) services. METHODS: We conducted a cross-sectional survey of mother-infant pairs attending week-6 or month-9 infant immunizations at 120 high-volume MCH clinics throughout Kenya. Clinics were selected using probability proportionate to size sampling. Women were interviewed using structured questionnaires and clinical data was verified using MCH booklets. Among married women, survey-weighted logistic regression models accounting for clinic-level clustering were used to compare outcomes by male ANC attendance and to identify its correlates. RESULTS: Among 2521 women attending MCH clinics and had information on male partner ANC attendance, 2141 (90%) were married of whom 806 (35%) had male partners that attended ANC. Among married women, male partner ANC attendance was more frequent among women with higher education, women who requested their partners to attend ANC, had male partners with higher education, did not report partner violence, and had disclosed their HIV status (p < 0·001 for each). Additionally, male ANC attendance was associated with higher uptake of ANC visits [adjusted Odds Ratio (AOR) = 1·67, 95% confidence interval (CI) 1·36-2·05,], skilled delivery (AOR = 2·00, 95% CI 1·51-2·64), exclusive breastfeeding (AOR = 1·70, 95% CI 1·00-2·91), infant Bacille Calmette Guerin (BCG) immunization (AOR = 3·59, 95% CI 1·00-12·88), and among HIV-infected women, antiretroviral drugs (aOR = 6·16, 95% CI 1·26-30·41). CONCLUSION: Involving male partners in MCH activities amplifies benefits of MCH services by engaging partner support for maternal uptake of services.


Assuntos
Vacina BCG/uso terapêutico , Serviços de Saúde Materno-Infantil/estatística & dados numéricos , Cuidado Pré-Natal , Cônjuges , Adolescente , Adulto , Instituições de Assistência Ambulatorial , Fármacos Anti-HIV/uso terapêutico , Aleitamento Materno/estatística & dados numéricos , Estudos Transversais , Parto Obstétrico , Escolaridade , Feminino , Infecções por HIV/tratamento farmacológico , Humanos , Quênia , Serviços de Saúde Materna , Gravidez , Complicações Infecciosas na Gravidez/tratamento farmacológico , Adulto Jovem
11.
BMC Public Health ; 19(1): 1144, 2019 Aug 20.
Artigo em Inglês | MEDLINE | ID: mdl-31429732

RESUMO

BACKGROUND: Cryptosporidiosis is a pathological condition caused by infection with coccidian protozoan parasites Cryptosporidium. Cryptosporidium is one of the most common causes of childhood diarrhea in developing countries. So far, no data has been published on its prevalence among children with diarrhea in Cameroon. This study was therefore, designed to assess the prevalence and risk factors associated with Cryptosporidiosis among children within the ages 0-5 years suffering from diarrhea and being attended to at the Limbe Regional Hospital. METHODS: The study was a hospital based analytical cross-sectional study involving children within the ages 0-5 years (n = 112) hospitalized or consulted in the pediatric departments of the hospital between April 2018 and May 2018. Stool specimens were processed using the modified acid-fast staining method, and microscopically examined for Cryptosporidium infection. RESULTS: A total of 112 participants were recruited out of which 67 presented with diarrhea. A high prevalence 9/67 (13.40%) of Cryptosporidium was noticed in children with diarrhea than children without diarrhea 1/45 (2.2%). There was a significant relationship (p = 0.041) between prevalence of Cryptosporidium and the presence of diarrhea in children within the ages 0-5 years in the Limbe Regional Hospital. It was realized that children from parents with primary level of education, children whose parents did not respect exclusive breastfeeding and those whose parents were giving them pipe borne water for drinking recorded a higher prevalence. CONCLUSIONS: This study revealed an overall prevalence of 8.9% for Cryptosporidium among children of ages 0-5 years that attended the Limbe Regional Hospital. The prevalence among children that presented with diarrhea was 13.4%. The study clearly demonstrated that Cryptosporidium is an important protozoal etiologic agent for children with diarrhea in Limbe.


Assuntos
Criptosporidiose/epidemiologia , Cryptosporidium , Diarreia/parasitologia , Animais , Aleitamento Materno/estatística & dados numéricos , Camarões/epidemiologia , Pré-Escolar , Estudos Transversais , Criptosporidiose/parasitologia , Países em Desenvolvimento , Escolaridade , Feminino , Hospitais/estatística & dados numéricos , Humanos , Lactente , Recém-Nascido , Masculino , Pais , Prevalência , Fatores de Risco
12.
MMWR Morb Mortal Wkly Rep ; 68(34): 745-748, 2019 Aug 30.
Artigo em Inglês | MEDLINE | ID: mdl-31465319

RESUMO

Surveillance of U.S. breastfeeding duration and exclusivity has historically reported estimates among all infants, regardless of whether they had initiated breastfeeding. These surveillance estimates have consistently shown that non-Hispanic black (black) infants are less likely to breastfeed, compared with other racial/ethnic groups.* Less is known about disparities in breastfeeding duration when calculated only among infants who had initiated breastfeeding, compared with surveillance estimates based on all infants. CDC analyzed National Immunization Survey-Child (NIS-Child) data for infants born in 2015 to describe breastfeeding duration and exclusivity at ages 3 and 6 months among all black and non-Hispanic white (white) infants, and among only those who had initiated breastfeeding. When calculated among all infants regardless of breastfeeding initiation, breastfeeding differences between black and white infants were 14.7 percentage points (95% confidence interval [CI] = 10.7-18.8) for any breastfeeding at age 3 months and were significantly different for both any and exclusive breastfeeding at both ages 3 and 6 months. Among only infants who had initiated breastfeeding, the magnitude of black-white differences in breastfeeding rates were smaller. This was most notable in rates of any breastfeeding at 3 months, where the percentage point difference between black and white infants was reduced to 1.2 (95% CI = -2.3-4.6) percentage points and was no longer statistically significant. Black-white disparities in breastfeeding duration result, in part, from disparities in initiation. Interventions both to improve breastfeeding initiation and to support continuation among black mothers might help reduce disparities.


Assuntos
Afro-Americanos/psicologia , Aleitamento Materno/etnologia , Grupo com Ancestrais do Continente Europeu/psicologia , Mães/psicologia , Adulto , Afro-Americanos/estatística & dados numéricos , Aleitamento Materno/psicologia , Aleitamento Materno/estatística & dados numéricos , Grupo com Ancestrais do Continente Europeu/estatística & dados numéricos , Disparidades nos Níveis de Saúde , Humanos , Lactente , Mães/estatística & dados numéricos , Fatores de Tempo , Estados Unidos , Adulto Jovem
13.
PLoS Med ; 16(8): e1002889, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-31454346

RESUMO

BACKGROUND: Evidence on the association between breastfeeding and later childhood obesity and blood pressure (BP) is inconsistent, especially in HIV-prevalent areas where, until recently, HIV-infected women were discouraged from breastfeeding, but obesity is increasingly prevalent. METHODS AND FINDINGS: The Siyakhula cohort (2012-2014), a population-based prospective cohort study, collected data over 3 visits on HIV-negative children ages 7 to 11 years in rural South Africa. We used weight (body mass index [BMI]), fat, and BP as outcome variables and incorporated early life (including mother's age at delivery and HIV status) and current life factors (including maternal education and current BMI). Our primary exposure was breastfeeding duration. We dichotomized 3 outcome measures using pre-established thresholds for clinical interpretability: (1) overfat: ≥85th percentile of body fat; (2) overweight: >1 SD BMI z score; and (3) prehypertension: ≥90th percentile for systolic BP (SBP) or diastolic BP (DBP). We modelled each outcome using multivariable logistic regression, including stopping breastfeeding, then early life, and finally current life factors. Of 1,536 children (mean age = 9.3 years; 872 girls; 664 boys), 7% were overfat, 13.2% overweight, and 9.1% prehypertensive. Over half (60%) of the mothers reported continued breastfeeding for 12+ months. In multivariable analyses, continued breastfeeding between 6 and 11 months was associated with approximately halved odds of both being overfat (adjusted odds ratio [aOR] = 0.43, 95% confidence interval [CI] 0.21-0.91, P = 0.027) and overweight (aOR = 0.46, CI 0.26-0.82, P = 0.0083), but the association with prehypertension did not reach statistical significance (aOR = 0.72, CI 0.38-1.37, P = 0.32). Children with a mother who was currently obese were 5 times more likely (aOR = 5.02, CI 2.47-10.20, P < 0.001) to be overfat and over 4 times more likely to be overweight (aOR = 4.33, CI 2.65-7.09, P < 0.001) than children with normal weight mothers. Differences between HIV-exposed and unexposed children on any of the outcomes were minimal and not significant. The main study limitation was that duration of breastfeeding was based on maternal recall. CONCLUSIONS: To our knowledge, this is the first study examining and quantifying the association between breastfeeding and childhood obesity in an African setting with high HIV prevalence. We observed that breastfeeding was independently associated with reduced childhood obesity for both HIV-exposed and unexposed children, suggesting that promoting optimal nutrition throughout the life course, starting with continued breastfeeding, may be critical to tackling the growing obesity epidemic. In the era of widespread effective antiretroviral treatment for HIV-infected women for life, these data further support the recommendation of breastfeeding for all women.


Assuntos
Aleitamento Materno/estatística & dados numéricos , Infecções por HIV/epidemiologia , Obesidade Pediátrica/epidemiologia , Pré-Hipertensão/epidemiologia , Criança , Feminino , Humanos , Masculino , Obesidade Pediátrica/etiologia , Pré-Hipertensão/etiologia , Prevalência , Estudos Prospectivos , Fatores de Risco , África do Sul/epidemiologia
14.
PLoS Med ; 16(8): e1002904, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-31469827

RESUMO

BACKGROUND: In Bangladesh, neonatal sepsis is the cause of 24% of neonatal deaths, over 65% of which occur in the early-newborn stage (0-6 days). Only 50% of newborns in Bangladesh initiated breastfeeding within 1 hour of birth. The mechanism by which early initiation of breastfeeding reduces neonatal deaths is unclear, although the most likely pathway is by decreasing severe illnesses leading to sepsis. This study explores the effect of breastfeeding initiation time on early newborn danger signs and severe illness. METHODS AND FINDINGS: We used data from a community-based trial in Bangladesh in which we enrolled pregnant women from 2013 through 2015 covering 30,646 newborns. Severe illness was defined using newborn danger signs reported by The Young Infants Clinical Science Study Group. We categorized the timing of initiation as within 1 hour, 1 to 24 hours, 24 to 48 hours, ≥48 hours of birth, and never breastfed. The analysis includes descriptive statistics, risk attribution, and multivariable mixed-effects logistic regression while adjusting for the clustering effects of the trial design, and maternal/infant characteristics. In total, 29,873 live births had information on breastfeeding among whom 19,914 (66.7%) initiated within 1 hour of birth, and 4,437 (14.8%) neonates had a severe illness by the seventh day after birth. The mean time to initiation was 3.8 hours (SD 16.6 hours). The proportion of children with severe illness increased as the delay in initiation increased from 1 hour (12.0%), 24 hours (15.7%), 48 hours (27.7%), and more than 48 hours (36.7%) after birth. These observations would correspond to a possible reduction by 15.9% (95% CI 13.2-25.9, p < 0.001) of severe illness in a real world population in which all newborns had breastfeeding initiated within 1 hour of birth. Children who initiated after 48 hours (odds ratio [OR] 4.13, 95% CI 3.48-4.89, p < 0.001) and children who never initiated (OR 4.77, 95% CI 3.52-6.47, p < 0.001) had the highest odds of having severe illness. The main limitation of this study is the potential for misclassification because of using mothers' report of newborn danger signs. There could be a potential for recall bias for mothers of newborns who died after being born alive. CONCLUSIONS: Breastfeeding initiation within the first hour of birth is significantly associated with severe illness in the early newborn period. Interventions to promote early breastfeeding initiation should be tailored for populations in which newborns are delivered at home by unskilled attendants, the rate of low birth weight (LBW) is high, and postnatal care is limited. TRIAL REGISTRATION: Trial Registration number: anzctr.org.au ID ACTRN12612000588897.


Assuntos
Aleitamento Materno/estatística & dados numéricos , Doenças do Recém-Nascido/epidemiologia , Doença Aguda , Fatores Etários , Bangladesh/epidemiologia , Feminino , Humanos , Lactente , Mortalidade Infantil , Recém-Nascido , Doenças do Recém-Nascido/mortalidade , Doenças do Recém-Nascido/prevenção & controle , Masculino , População Rural/estatística & dados numéricos , Adulto Jovem
15.
Rev Esp Salud Publica ; 932019 Aug 02.
Artigo em Espanhol | MEDLINE | ID: mdl-31368457

RESUMO

OBJECTIVE: Increasing breastfeeding rates is a desirable goal for improving maternal and child health. Pediatricians have a main role in this subject. The objective was to document breastfeeding knwoledge in Pediatric residents, and its relationship with the BFHI (Baby Friendly Hospital Initiative) status of their hospitals. METHODS: Transversal study with a validated online survey (ECoLa). Polietapic sampling of Pediatric residentes in Spain by strata (BFHI degree) and clusters (hospitals). Estimated sample size was 142 residents. 312 surveys were sent to 21 hospitals. Main variable was the percentage of correct answers to survey questions, it was analyzed with non parametric techniques. RESULTS: 189 answers (response rate 60%). Global median (Me) of correct answers was 76.9% (95% Confidence Interval [95CI] 74.2-79.6). There was no difference among first and second year residents (Me=76.9%) and third and fourth year residents (Me=73.1%) (p=0.541). Residents from BFHI hospitals (Me=84.6%) achieved better results than those from non-BFHI hospitals (Me=73.1%) (p=0.002). Variability at non-BFHI hospitals was considerable, where some hospitals showed unacceptable scores. Prevalence of courses was greater at BFHI hospitals (95% vs 52%). CONCLUSIONS: There are some deficiencies in Pediatric residents' breastfeeding training. There are hospitals whose residents have an insufficient breastfeeding knowledge. No low scores were found in residents from BFHI hospitals. We consider neccesary to systematize and universalize breastfeeding training during Pediatric Residency.


Assuntos
Atitude Frente a Saúde , Aleitamento Materno/estatística & dados numéricos , Promoção da Saúde/métodos , Hospitais/estatística & dados numéricos , Pediatria/normas , Adulto , Estudos Transversais , Feminino , Humanos , Internato e Residência , Masculino , Mães , Prevalência , Espanha/epidemiologia , Inquéritos e Questionários , Adulto Jovem
16.
Int J Public Health ; 64(8): 1183-1192, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31363789

RESUMO

OBJECTIVES: This study (1) examines spatio-temporal variation in diarrhoea prevalence and (2) for 2013 identifies and maps the factors associated with diarrhoea prevalence at district level. METHODS: Data were drawn from Demographic Health Surveys (1990, 1999, 2003, 2008 and 2013). Moran index was used to analyse spatial dependence and clustering of diarrhoea prevalence in 2008 and 2013. Geographical Weighted Poisson Regression analysis was used to identify factors associated with diarrhoea prevalence for 2013. RESULTS: Diarrhoea prevalence was higher in rural than in urban areas. Prevalence exhibited statistically significant spatial variation, but temporal variation and spatial dependence were not significant. Locally, diarrhoea prevalence hot spots clustered among five states in the North East zone. Non-improved sanitation, children 6-23 months not breastfed, dung floor, relative poverty, unemployed mothers and Gini coefficient were main predictors of diarrhoea prevalence. CONCLUSIONS: Results of spatial analysis improved understanding of local spatio-temporal variation in diarrhoea prevalence and underlying factors. Intervention strategies should emphasize behaviour change regarding washing of hands and feeding utensils before and after feeding children, exclusive breastfeeding, safe water, improved sanitation and hygiene, particularly in hot spot states.


Assuntos
Diarreia/epidemiologia , Promoção da Saúde , Higiene , Aleitamento Materno/estatística & dados numéricos , Criança , Pré-Escolar , Análise por Conglomerados , Diarreia/etiologia , Diarreia/prevenção & controle , Água Potável , Feminino , Promoção da Saúde/métodos , Inquéritos Epidemiológicos , Humanos , Lactente , Masculino , Nigéria/epidemiologia , Prevalência , População Rural , Saneamento
17.
Rev Esc Enferm USP ; 53: e03480, 2019 Jul 29.
Artigo em Português, Inglês | MEDLINE | ID: mdl-31365726

RESUMO

OBJECTIVE: To analyze the maternal characteristics and perinatal and the first year outcomes of life according to the self-reported color of the mothers. METHOD: Cohort study with mothers and their babies developed in a city in the interior of São Paulo. Follow-up occurred from June 2015 to February 2017. Data were collected at five moments: in the first month and at three, six, nine and 12 months of the child's life. Sociodemographic variables related to prenatal and delivery were included in the study. Among the perinatal outcomes, we analyzed the birth weight and the need for hospitalization in neonatal units; for the outcomes of the first year of life, the occurrence of respiratory infection and the breastfeeding duration were measured. RESULTS: A total of 507 mothers participated in the study. Black/brown women presented an unfavorable socio-demographic situation when compared to white women. The only more favorable outcome among black/brown women was the breastfeeding duration. CONCLUSION: Despite the unfavorable socio-demographic situation considering the selected outcomes, black/brown women did not have worse results. The hypothesis that the quality of care may negate the negative effects of their sociodemographic conditions needs to be tested in future studies.


Assuntos
Grupo com Ancestrais do Continente Africano/estatística & dados numéricos , Aleitamento Materno/estatística & dados numéricos , Grupo com Ancestrais do Continente Europeu/estatística & dados numéricos , Hospitalização/estatística & dados numéricos , Mães/estatística & dados numéricos , Brasil/epidemiologia , Estudos de Coortes , Feminino , Seguimentos , Humanos , Lactente , Recém-Nascido , Gravidez , Resultado da Gravidez/epidemiologia , Estudos Prospectivos , Infecções Respiratórias/epidemiologia , Pigmentação da Pele , Fatores de Tempo , Adulto Jovem
18.
Enferm. clín. (Ed. impr.) ; 29(4): 207-215, jul.-ago. 2019. graf, tab
Artigo em Espanhol | IBECS | ID: ibc-182914

RESUMO

Objetivo: Conocer la experiencia personal y sentimientos de las mujeres primíparas que se vieron obligadas a abandonar la lactancia materna (LM) antes del tiempo previsto inicialmente por cada mujer, así como las causas del abandono y el papel de los profesionales sanitarios. Método: Estudio cualitativo fenomenológico mediante entrevista semiestructurada. Se realizó un muestreo opinático mediante informadores clave, hasta alcanzar la saturación de la información. Se realizó análisis de contenido cualitativo para generar códigos y asignar categorías. Resultados: Se entrevistaron 15 mujeres de 33,1 (DE 5,4) años. Se constató ambivalencia de sentimientos, considerando que la LM es una experiencia satisfactoria a la par que sacrificada y dolorosa. Las mujeres referían escasez de conocimientos. La inseguridad sobre la alimentación y el dolor físico fueron las causas más importantes para el abandono. Se evidenció además una dualidad de sentimientos entre la tranquilidad que supone la alimentación artificial, al saber que el niño está bien alimentado, y la sensación de culpabilidad por no haber mantenido la LM. Consideraron que los profesionales no realizan adecuadamente su labor de promoción de la LM, refiriendo numerosas ocasiones en las que los propios profesionales sanitarios efectuaron prácticas contrarias a su instauración y mantenimiento. Conclusiones: En el relato de las madres se constatan necesidades formativas y de soporte emocional insuficientemente cubiertas. Las enfermeras implicadas en la atención de estas mujeres deberían explorar sistemáticamente dichas necesidades


Objective: The aim of this study was to discover the personal experience and feelings of primiparous women who had to abandon breastfeeding (BF) before the expected time, as well as the causes of abandonment and the role of health professionals. Method: A qualitative study through semi-structured interview was carried out. A purposive sampling by key informants was conducted, until saturation of the information was reached. Qualitative content analysis was carried out to generate codes and assign categories. Results: We interviewed 15 women aged 33.1 (SD 5.4) years. Ambivalent feelings were found, while BF was considered a satisfying experience, it was also sacrificial and painful. They refer to a lack of knowledge, and insecurity about nourishing their infant and physical pain seem to be the most important reasons for giving up. There is also a duality of feelings between the peace of mind afforded by artificial feeding, knowing that their child is well nourished, and the feeling of guilt for not having maintained BF. They believe that professionals do not adequately perform their work to promote BF, referring to numerous occasions when health professionals themselves have performed practices contrary to its establishment and maintenance. Conclusions: In the mothers' account, emotional training and emotional support needs are insufficiently covered. Nursing professionals involved in the care of these women should systematically explore these needs


Assuntos
Humanos , Feminino , Adolescente , Adulto , Aleitamento Materno/estatística & dados numéricos , Conhecimentos, Atitudes e Prática em Saúde , Apoio Social , Comportamento Materno/psicologia , Desmame , Cuidados de Enfermagem , Aleitamento Materno/métodos , Análise Qualitativa
19.
Cien Saude Colet ; 24(7): 2387-2397, 2019 Jul 22.
Artigo em Português, Inglês | MEDLINE | ID: mdl-31340258

RESUMO

OBJECTIVE: To verify the association of maternal and anthropometric factors with consumption of ultra-processed foods in children between 4 to 24 months. METHODS: cross-sectional study with 300 children hospitalized in a tertiary hospital and their mothers. The interview took place during the first 72 hours of hospitalization to avoid interference in the responses about the child's diet. Maternal factors investigated: age, schooling, income, parity, BMI and guidance on complementary feeding. Variables related to the child investigated: age, breastfeeding, infant school, BMI/age, height/age, weight/age and introduction of ultra-processed food. The association between the factors studied and introduction of ultra-processed food was tested by linear regression. The significance level considered was 0.05. RESULTS: . It was verified that only 21% of the children had not yet received any type of ultra-processed food, and 56.5% received any of these foods before 6 months. In the multivariate analysis, maternal schooling, family income, maternal age and parity were associated with ultra-processed food supply. CONCLUSIONS: The feeding practices of children between 4 and 24 months are inadequate when compared to the recommendations for the age group.


Assuntos
Fast Foods/estatística & dados numéricos , Comportamento Alimentar , Hospitalização , Fenômenos Fisiológicos da Nutrição do Lactente , Adulto , Aleitamento Materno/estatística & dados numéricos , Estudos Transversais , Feminino , Humanos , Lactente , Entrevistas como Assunto , Masculino , Mães/estatística & dados numéricos , Adulto Jovem
20.
Ceska Gynekol ; 84(3): 201-207, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31324110

RESUMO

OBJECTIVE: To compare the performance of obstetrical interventions and maternal and perinatal outcomes between vaginal and cesarean delivery routes in pregnant women at normal risk. Type of article: Original article. Desing: Cross-sectional study with 421 participants admitted for spontaneous or induced labor with full-term singleton gestations and fetuses weighing between 2,500 and 4,499 g. SETTING: Maternal Fetal-Medicine Service, Assis Chateaubriand Maternity, Federal University of Ceará (UFC), Fortaleza-CE, Brazil. METHODS: The instrument of data collection was divided into socio-demographic, clinical, and obstetric characteristics; data of labor and delivery; maternal morbidity; maternal outcome and perinatal outcomes. Pearsons chi-square test and Fishers exact test were used to verify associations between the groups. RESULTS: The mean age was 22.8 ± 6.0 (vaginal) and 22.9 ± 4.9 (cesarean section). Overall, 44.5% of vaginal deliveries and 85.5% of cesarean sections were monitored electronically (p < 0.001). Immediate skin-to-skin contact (84.1%) and first-hour breastfeeding (80.4%) were more frequent in vaginal deliveries compared with cesarean deliveries (27% vs. 61.0%, p < 0.001). The prevalence of puerperal infections was 1.2% (vaginal) and 5.0% (cesarean section) with a p value of 0.02; 40% of cesarean-delivered newborns and 9.7% of vaginally-delivered newborns were referred to the neonatal intensive care unit (p < 0.001). CONCLUSION: The cesarean section was associated with a lower frequency of useful practices, a higher frequency of harmful practices, worse neonatal outcomes, and a higher rate of postpartum infections.


Assuntos
Cesárea/estatística & dados numéricos , Parto Obstétrico/estatística & dados numéricos , Brasil/epidemiologia , Aleitamento Materno/estatística & dados numéricos , Estudos Transversais , Parto Obstétrico/métodos , Feminino , Humanos , Recém-Nascido , Trabalho de Parto Induzido , Gravidez , Resultado da Gravidez , Infecção Puerperal/epidemiologia
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