Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 833
Filtrar
1.
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
2.
South Med J ; 112(10): 512-519, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31583410

RESUMO

OBJECTIVES: To determine the comparative impact of the standard Parents as Teachers (PAT) to the nutrition and physical activity enhanced version (PATE) of the perinatal educational curriculum on compliance with infant feeding recommendations and changes in maternal infant feeding knowledge and beliefs. METHODS: Women at least 18 years of age, <19 weeks pregnant, and residing in three Mississippi counties were randomized to the standard PAT or the PATE version of the perinatal educational curriculum. Infant diets were assessed via 24-hour diet recall at postnatal months 1 to 12. Maternal knowledge and beliefs about infant feeding were assessed via survey at baseline and postnatal month 12. Compliance with infant feeding recommendations and differences in compliance between treatment arms were assessed using Kaplan-Meier survival curves. Longitudinal changes in maternal knowledge and beliefs were assessed with McNemar tests of symmetry. RESULTS: Postnatal retention for the PAT and PATE arms were 83% (25/30) and 88% (21/24). Compliance with feeding recommendations for PAT and PATE participants, respectively, was 40% and 63% for no solid food before 6 months; 23% and 21% for no sugar-sweetened beverages before 12 months; 100% (both) for no fruit juice before 6 months; and 43% and 46% for no snack chips, French fries, and other fried food and candy before 12 months. Median times to feeding sugar-sweetened beverages were 10.1 and 9.6 months in PAT and PATE arms. Significant differences in compliance between arms were not found (P > 0.05). Participants' knowledge and beliefs about infant feeding were generally in agreement with expert recommendations at baseline, with few changes over time or between arms. CONCLUSIONS: Findings suggest the need for further intervention focused on translating knowledge into action to improve diets of weaning infants in this region of the United States.


Assuntos
Afro-Americanos , Aleitamento Materno/etnologia , Currículo , Exercício/fisiologia , Promoção da Saúde/organização & administração , Saúde Materna , Mães/educação , Educação de Pacientes como Assunto/organização & administração , Adulto , Feminino , Humanos , Gravidez , Estados Unidos , Adulto Jovem
3.
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
4.
Int J Circumpolar Health ; 78(1): 1629784, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31221048

RESUMO

Seasonal patterns of neonatal mortality and stillbirths have been found around the world. However, little is known about the association between season of birth and infant mortality of pre-industrial societies in a subarctic environment. In this study, we compared how season of birth affected the neonatal and stillbirth risk among the Sami and non-Sami in Swedish Sápmi during the nineteenth century. Using digitised parish records from the Demographic Data Base at Umeå University, we applied logistic regression models for estimating the association of season of birth with stillbirths and neonatal mortality, respectively. Higher neonatal mortality was found among the winter- and autumn-born Sami, compared to summer-born infants. Stillbirth risk was higher during autumn compared to summer among the Sami, whereas we found no seasonal differences in mortality among the non-Sami population. We relate the higher neonatal mortality risk among winter-born Sami to differences in seasonality of living conditions associated with reindeer herding.


Assuntos
Mortalidade Infantil/etnologia , Mortalidade Infantil/tendências , Estações do Ano , Natimorto/etnologia , Regiões Árticas/epidemiologia , Aleitamento Materno/etnologia , Feminino , Humanos , Lactente , Masculino , Fatores Socioeconômicos , Suécia/epidemiologia
5.
Pediatrics ; 144(1)2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-31213519

RESUMO

OBJECTIVES: Among very low birth weight infants born from January 2015 to December 2017, the Massachusetts statewide quality improvement collaborative aimed to increase provision of (1) any mother's milk at discharge or transfer from a baseline of 63% to ≥75%, (2) exclusive mother's milk at discharge or transfer from a baseline of 45% to ≥55%, and (3) to reduce racial and ethnic disparities in provision of mother's milk. METHODS: We used the Institute for Healthcare Improvement Breakthrough Series framework in which our main process measures were receipt of prenatal education regarding human milk education, first milk expression within 6 hours after birth, and any skin-to-skin care on 4 weekly audit days in the first month. We examined changes over time among all very low birth weight infants and for 3 racial and ethnic subgroups (non-Hispanic white, non-Hispanic black, and Hispanic) using control and run charts, respectively. RESULTS: Of 1670 infants eligible to receive mother's milk at 9 hospitals, 43% of their mothers were non-Hispanic white, 19% were non-Hispanic black, 19% were Hispanic, 11% were of other races or ethnicities, and 7% were unknown. Hospital teams conducted 69 interventions. We found improvement in all 3 process measures but not for our main outcomes. Improvements in process measures were similar among racial and ethnic subgroups. Hospitals varied substantially in the rate of any mother's milk at discharge or transfer according to race and ethnicity. CONCLUSIONS: Our collaborative achieved similar improvements in process measures focused within the first month of hospitalization among all racial and ethnic subgroups. Reduction in racial and ethnic disparities in mother's milk at discharge was not reached. Future efforts will focus on factors that occur later in the hospitalization.


Assuntos
Aleitamento Materno/estatística & dados numéricos , Disparidades em Assistência à Saúde/estatística & dados numéricos , Cuidado do Lactente/normas , Recém-Nascido de muito Baixo Peso , Terapia Intensiva Neonatal/normas , Melhoria de Qualidade , Aleitamento Materno/etnologia , Aleitamento Materno/métodos , Aleitamento Materno/psicologia , Grupos Étnicos , Feminino , Disparidades nos Níveis de Saúde , Disparidades em Assistência à Saúde/etnologia , Humanos , Cuidado do Lactente/métodos , Cuidado do Lactente/estatística & dados numéricos , Recém-Nascido , Recém-Nascido Prematuro , Terapia Intensiva Neonatal/estatística & dados numéricos , Masculino , Massachusetts
6.
Ecol Food Nutr ; 58(4): 301-316, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31035771

RESUMO

A large urban hospital in Florida implemented changes to achieve the Baby-Friendly Hospital Initiative (BFHI) designation in 2015 resulting in an increase of exclusive breastfeeding rates at hospital discharge; however, African American women continue to have the lowest rates overall. Qualitative interviews were conducted with 20 African American women who received prenatal care at a low-income women's clinic and gave birth at an affiliated BFHI hospital. Using a medical anthropology analytical framework to examine predisposing, enabling, and service-related factors that affect breastfeeding, this study investigated interpersonal, sociocultural, and institutional barriers to breastfeeding. Common challenges experienced by participants included lack of maternity leave from work, lack of access to electric pumps, social pressures to initiate formula supplementation, fears that breastfeeding renders infants overly dependent on their mother's care, and a lack of breastfeeding role models and/or support networks to normalize longer-term breastfeeding. We conclude that efforts to increase breastfeeding rates for African American women and promote culturally sensitive interventions must address underlying socioeconomic and structural barriers, women's perceptions of breastfeeding benefits and difficulties, and the need for improvements in postnatal lactation and doula support to foster a more inclusive culture of breastfeeding.


Assuntos
Afro-Americanos , Aleitamento Materno , Mães , Adulto , Afro-Americanos/psicologia , Aleitamento Materno/etnologia , Aleitamento Materno/psicologia , Feminino , Florida , Grupos Focais , Promoção da Saúde , Hospitais , Humanos , Lactente , Alimentos Infantis , Recém-Nascido , Mães/psicologia , Pobreza , Pesquisa Qualitativa , Apoio Social
7.
Int J Circumpolar Health ; 78(1): 1604062, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31008692

RESUMO

This symposium report provides a brief overview of the six programmes and studies on parental education and maternal health services within the circumpolar region presented in the symposium "parental education" at the 17th International Congress of Circumpolar Health in Copenhagen, Denmark, August 2018.


Assuntos
Serviços de Saúde Materna/organização & administração , Pais/educação , Regiões Árticas , Aleitamento Materno/etnologia , Desenvolvimento Infantil , Competência Cultural , Humanos , Lactente , Recém-Nascido , Serviços de Saúde Materna/normas , Mães/educação , Poder Familiar/etnologia , Indicadores de Qualidade em Assistência à Saúde
8.
Epidemiology ; 30(3): 449-457, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-30964816

RESUMO

BACKGROUND: Data on breastfeeding and breast cancer risk are sparse and inconsistent for Hispanic women. METHODS: Pooling data for nearly 6,000 parous Hispanic women from four population-based studies conducted between 1995 and 2007 in the United States and Mexico, we examined the association of breastfeeding with risk of breast cancer overall and subtypes defined by estrogen receptor (ER) and progesterone receptor (PR) status, and the joint effects of breastfeeding, parity, and age at first birth. We calculated odds ratios (ORs) and 95% confidence intervals (CIs) using logistic regression. RESULTS: Among parous Hispanic women, older age at first birth was associated with increased breast cancer risk, whereas parity was associated with reduced risk. These associations were found for hormone receptor positive (HR+) breast cancer only and limited to premenopausal women. Age at first birth and parity were not associated with risk of ER- and PR- breast cancer. Increasing duration of breastfeeding was associated with decreasing breast cancer risk (≥25 vs. 0 months: OR = 0.73; 95% CI = 0.60, 0.89; Ptrend = 0.03), with no heterogeneity by menopausal status or subtype. At each parity level, breastfeeding further reduced HR+ breast cancer risk. Additionally, breastfeeding attenuated the increase in risk of HR+ breast cancer associated with older age at first birth. CONCLUSIONS: Our findings suggest that breastfeeding is associated with reduced risk of both HR+ and ER- and PR- breast cancer among Hispanic women, as reported for other populations, and may attenuate the increased risk in women with a first pregnancy at older ages.


Assuntos
Aleitamento Materno/etnologia , Neoplasias da Mama/etnologia , Hispano-Americanos/estatística & dados numéricos , Paridade , Receptores Estrogênicos/análise , Receptores de Progesterona/análise , Adulto , Idoso , Aleitamento Materno/estatística & dados numéricos , Feminino , Humanos , México/epidemiologia , Pessoa de Meia-Idade , Gravidez , Fatores de Risco , Estados Unidos/epidemiologia
9.
Breastfeed Med ; 14(4): 249-255, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-30839228

RESUMO

Background: The incidence of diabetes is rising, and with it, the number of pregnancies affected by diabetes. U.S. black women have a disproportionately high prevalence of diabetes and lower rates of breastfeeding. Objective: The objective of this study was to quantify the relationship between diabetes before pregnancy and breastfeeding duration among black women in the United States. Materials and Methods: We analyzed women from the Black Women's Health Study (N = 59,000) to assess the relationship between prepregnancy diabetes and time to breastfeeding cessation occurring up to 24 months postdelivery using Kaplan-Meier survival curves, log rank tests, and Cox proportional hazards models. The study population included primiparous women with births between 1995 and 2009 (N = 3,404). Obesity, hypertension before pregnancy, and family history of diabetes were examined for effect modification. Results: Survival curves demonstrated a markedly reduced duration of breastfeeding in women who had been diagnosed with prepregnancy diabetes (p < 0.01). The hazard ratio for breastfeeding cessation for women with prepregnancy diabetes was 1.5 (95% confidence interval 1.1-2.0) compared with women without prepregnancy diabetes after control for age, body mass index (BMI) at age 18, prepregnancy BMI, other metabolic factors, demographics, and health behaviors. Conclusions: Our results suggest that prepregnancy diabetes is a strong predictor of curtailed breastfeeding duration, even after control for BMI. This underscores the need for targeted lactation support for diabetic women.


Assuntos
Afro-Americanos , Aleitamento Materno/etnologia , Obesidade/etnologia , Gravidez em Diabéticas/etnologia , Adulto , Índice de Massa Corporal , Feminino , Humanos , Estimativa de Kaplan-Meier , Gravidez , Modelos de Riscos Proporcionais , Fatores de Tempo , Estados Unidos/epidemiologia
10.
J Nepal Health Res Counc ; 16(41): 385-391, 2019 Jan 28.
Artigo em Inglês | MEDLINE | ID: mdl-30739925

RESUMO

BACKGROUND: Timely initiation of breastfeeding has the potential to prevent 22% of neonatal deaths if breastfed within an hour after birth. Although breastfeeding is almost universal in Nepal, ranges of regional differences in timely initiation of breastfeeding have been documented. The aim of this study was to identify the prevalance and the determinants of early initiation of breastfeeding among disadvantaged ethnic women in Midwest Nepal. METHODS: The data was obtained from a household survey of women who had their last child less than one year of age. Descriptive statistics were used to analyze respondents' demographic, socioeconomic, obstetric and health services related characteristics. Determinants of timely initiation of breastfeeding were assessed using univariate analysis and further evaluated using multivariable logistic regression analysis. RESULTS: Of 362 mothers, 65.5% initiated breastfeeding within one hour of childbirth. Mothers belonging to Tharu ethnic groups (aOR 1.788; 95% CI: 1.014, 3.152), health facility delivery (aOR 3.381; 95% CI: 1.795, 6.369) and mothers who were counseled on breastfeeding during ANC attendance (aOR 2.898; 95% CI: 1.038, 8.096) were more likely to initiate breastfeeding within the first hour of child birth. CONCLUSIONS: Almost two in every three mothers had initiated breastfeeding within one hour of childbirth. The factors influencing timely initiation of breastfeeding were Tharu ethnic mothers, health facility delivery and Ante Natal Care counseling. We need to aim at increasing institutional deliveries and counseling during ANC which may increase the early initiation of breastfeeding among disadvantaged ethnic groups.


Assuntos
Aleitamento Materno/estatística & dados numéricos , Grupos Étnicos/estatística & dados numéricos , Adulto , Aleitamento Materno/etnologia , Feminino , Humanos , Recém-Nascido , Nepal , Fatores Socioeconômicos , Inquéritos e Questionários , Fatores de Tempo , Populações Vulneráveis/estatística & dados numéricos , Adulto Jovem
11.
MCN Am J Matern Child Nurs ; 44(2): 80-85, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30807326

RESUMO

There is a growing Orthodox Jewish population in the United States and Canada. Many Orthodox Jewish families have a large number of children and choose to breastfeed. The Orthodox Jew observes Jewish laws and customs literally as dictated by the Torah. Orthodox Jews consult a rabbi or posek before making most major life decisions, including matters related to breastfeeding to ensure adherence to religious law. Cultural practices applicable to the Orthodox Jewish family related to the provision of human milk and breastfeeding when a sick newborn may require special care and continued hospitalization after the mother has been discharged are presented. Guidelines for preconception lactation counseling for families are provided to tailor nursing care to meet the individual needs of each Orthodox Jewish infant and family. Special considerations related to pumping schedule, use of mechanisms such as timers for breast pumps, and discussions with religious leader about the saving of colostrum and/or milk when an infant is critically ill will be addressed. To provide culturally sensitive and appropriate counseling related to the provision of human milk and breastfeeding, nurses need to be culturally aware of the specific needs of the Orthodox Jewish family. Clinical implications and suggestions are provided.


Assuntos
Aleitamento Materno/psicologia , Relações Familiares/psicologia , Fidelidade a Diretrizes/normas , Judaísmo/psicologia , Adulto , Aleitamento Materno/etnologia , Aleitamento Materno/métodos , Assistência à Saúde Culturalmente Competente/normas , Relações Familiares/etnologia , Feminino , Hospitalização/estatística & dados numéricos , Humanos , Lactente , Recém-Nascido , Estudos Longitudinais , Masculino , Relações Mãe-Filho/etnologia , Relações Mãe-Filho/psicologia , Fatores de Risco
12.
Matern Child Health J ; 23(6): 858-867, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30659460

RESUMO

Objectives This study examines the associations between specific maternity care practices and breastfeeding duration for Spanish-speaking Hispanic, English-speaking Hispanic, non-Hispanic Native American, and non-Hispanic White women. Methods We analyzed data from the 2012-2014 New Mexico Pregnancy Risk Assessment Monitoring System. We used survey language as a proxy measure of acculturation and categorized women as Spanish-speaking Hispanic, English-speaking Hispanic, non-Hispanic Native American, and non-Hispanic White. We conducted bivariate analyses to compare rates of breastfeeding at 2 months and experiences of maternity care practices and logistic regression analysis to estimate the effects of these practices on breastfeeding duration for each group. Results Hispanic women were less likely than non-Hispanic women to breastfeed for at least 2 months (67.9% vs. 76.6%; p = 0.000); however, this varied significantly by acculturation level: 78.1% of Spanish-speaking Hispanic women compared to 66.1% of English-speaking Hispanic women breastfed for at least 2 months (p = 0.000). The effects of specific maternity care practices on duration varied across groups. Among non-Hispanic White, Native American, and English-speaking Hispanic women, breastfeeding while at the hospital had the strongest effect (AOR 2.09, 95% CI 1.67-2.61; AOR 2.71, 95% CI 2.08-3.52; and AOR 1.99, 95% CI 1.76-2.25, respectively). Among Spanish-speaking Hispanic women, being encouraged to breastfeed on demand had the strongest effect (AOR 5.179, 95% CI 3.86-6.94). Conclusions for Practice The effects of maternity care practices on breastfeeding duration vary by race, ethnicity, and acculturation level. Health care systems must acknowledge the diversity of their patient populations when seeking to develop and implement breastfeeding-friendly practices.


Assuntos
Aculturação , Aleitamento Materno/etnologia , Grupo com Ancestrais do Continente Europeu/estatística & dados numéricos , Hispano-Americanos/estatística & dados numéricos , Índios Norte-Americanos/estatística & dados numéricos , Cuidado do Lactente/métodos , Comportamento Materno/etnologia , Mães/estatística & dados numéricos , Cuidado Pós-Natal/métodos , Adolescente , Adulto , Aleitamento Materno/estatística & dados numéricos , Grupos Étnicos/estatística & dados numéricos , Feminino , Humanos , Recém-Nascido , Vigilância da População , Gravidez , Fatores Socioeconômicos , Adulto Jovem
13.
BMC Pregnancy Childbirth ; 19(1): 44, 2019 Jan 28.
Artigo em Inglês | MEDLINE | ID: mdl-30691401

RESUMO

BACKGROUND: Benefits of breastfeeding on the health of children, mothers and society are well known. However, breastfeeding rates vary according to the population examined. Chinese-born women migrated to high-income countries have shown low breastfeeding rates. Nevertheless, studies comparing breastfeeding rates of Chinese-born immigrants and natives are scarce. The aims of this study were therefore: 1) to compare the rate of exclusive breastfeeding at hospital discharge after giving birth between Chinese-born women resident in Spain and native Spanish women, 2) to assess the influence of the biological, socioeconomic, work-related and cultural factors on exclusive breastfeeding in women of Chinese origin. METHODS: A cross-sectional descriptive study with between group comparisons. This study included 73 postpartum women (33 Chinese-born and 40 native Spanish women). The association between exclusive breastfeeding and the country of origin was assessed by binary logistic regression. RESULTS: Native Spanish women showed a greater prevalence of exclusive breastfeeding (80%) compared to Chinese born immigrant women (36.4%) (adjusted for socioeconomic status, parental level of education, age, cesareans and birth weight) (OR = 0.21; 95% CI 0.05-0.91; p = 0.037). However, in other models that considered both work and cultural influences, no differences were observed. DISCUSSION: The classic biological and socioeconomic variables (educational and socioeconomic levels) do not seem to explain the lower rates of exclusive breastfeeding among Chinese immigrant women. This paradigm of inequity appears to be based on both the work conditions as well as cultural characteristics of Chinese born women in Spain, such as their overall attitude towards breastfeeding.


Assuntos
Grupo com Ancestrais do Continente Asiático/estatística & dados numéricos , Atitude Frente a Saúde/etnologia , Aleitamento Materno/etnologia , Emigrantes e Imigrantes/estatística & dados numéricos , Período Pós-Parto/psicologia , Adulto , Aleitamento Materno/psicologia , Estudos Transversais , Emigrantes e Imigrantes/psicologia , Feminino , Humanos , Recém-Nascido , Mães/psicologia , Gravidez , Fatores Socioeconômicos , Espanha , Adulto Jovem
14.
BMC Pregnancy Childbirth ; 19(1): 8, 2019 Jan 07.
Artigo em Inglês | MEDLINE | ID: mdl-30616549

RESUMO

BACKGROUND: Adverse health outcomes are higher among Maasai children in the Ngorongoro Conservation Area compared to other co-located ethnic groups and regions of Tanzania. The Mama Kwanza Socioeconomic Health Initiative, a Canadian-Tanzanian partnership delivering healthcare at clinics in this region, gathered perceptions of mothers regarding breastfeeding and infant nutrition in order to inform culturally sensitive, realistic, and effective health promotion efforts. METHODS: A qualitative description approach was used in interviewing 30 Maasai mothers of infants zero to six months of age to explore their infant feeding practices, beliefs, knowledge, and recommendations to support breastfeeding. A local research team was trained to conduct and transcribe the interviews and assist with data interpretation. Qualitative content analysis was used in analyzing the interview transcripts. RESULTS: Lactation is universal in this culture with all the mothers planning to breastfeed for at least one year and most having initiated breastfeeding within one hour of birth. Lactation skills and knowledge are passed down intergenerationally from the elder women. None of the infants less than six months were exclusively breastfed, with a variety of liquid and semi-solid supplements given. Mothers perceived their milk alone was nutritionally insufficient with maternal dietary deficiencies cited as a factor. CONCLUSIONS: While there is a strong breastfeeding culture among the Maasai in Ngorongoro, intersectoral efforts are required to provide culturally respectful health education on the benefits of exclusive breastfeeding and to ensure the maternal dietary adequacy required to achieve this goal. The findings reinforce the importance of international health projects adapting health promotion initiatives to local realities and beliefs in efforts to improve maternal child health.


Assuntos
Aleitamento Materno/psicologia , Grupos Étnicos/psicologia , Conhecimentos, Atitudes e Prática em Saúde/etnologia , Promoção da Saúde/métodos , Mães/psicologia , Adulto , Aleitamento Materno/etnologia , Canadá , Assistência à Saúde Culturalmente Competente/métodos , Feminino , Humanos , Recém-Nascido , Cooperação Internacional , Percepção , Gravidez , Pesquisa Qualitativa , Tanzânia/etnologia , Adulto Jovem
15.
J Immigr Minor Health ; 21(1): 89-97, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-29397484

RESUMO

Childhood obesity is increasing especially in Latinos and early intervention is essential to prevent later obesity complications. Latino children (n = 201) recruited at two San Francisco hospitals were assessed at birth including infant anthropometrics and feeding practices and followed to age 9 with annual anthropometric assessments. We evaluated the relationship between perinatal risk factors and obesity at age 9 and chronic obesity (obesity at both 5 and 9 years). Higher birthweight [odds ratio (OR) 2.48, 95% confidence interval (CI) 1.06-5.81] and maternal pre-pregnancy body mass index (BMI) (OR 1.09, 95% CI 1.00-1.18) were associated with increased risk for obesity at 9 years. Higher maternal pre-pregnancy BMI (OR 1.10, 95% CI 1.01-1.20) was associated with chronic obesity. Additionally, prenatal depression symptoms were protective (OR 0.33, 95% CI 0.11-0.94) against chronic obesity. We found no association between maternal age and education, exclusive breastfeeding at 4-6 weeks, rapid infant weight gain, and obesity or chronic obesity. Perinatal risk factors for obesity including higher birthweight and maternal pre-pregnancy BMI persisted until age 9, whereas, other variables significant at age 5 in our cohort and other populations including exclusive breastfeeding and rapid infant weight gain were no longer associated with increased risk.


Assuntos
Peso ao Nascer , Hispano-Americanos/estatística & dados numéricos , Mães/estatística & dados numéricos , Obesidade Pediátrica/etnologia , Índice de Massa Corporal , Pesos e Medidas Corporais , Aleitamento Materno/etnologia , Criança , Pré-Escolar , Doença Crônica , Estudos de Coortes , Feminino , Humanos , Modelos Logísticos , Masculino , Saúde Mental , Fatores de Risco , São Francisco/epidemiologia , Fatores Socioeconômicos
16.
Women Birth ; 32(3): e315-e322, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30104173

RESUMO

BACKGROUND: Benefits of breastfeeding are well-established. Few studies have examined initiation and duration of breastfeeding of Aboriginal infants. METHODS: Population-based study of women giving birth to an Aboriginal infant in South Australia, July 2011-June 2013. FINDINGS: 344 women took part. Participants were representative in relation to maternal age, infant birthweight and gestation. Eighty-six percent initiated breastfeeding, declining to 54% at 12 weeks postpartum. Women living in remote areas were more likely to be breastfeeding at 12 weeks than women living in Adelaide (Odds Ratio=2.6, 95% Confidence Interval 1.5-4.7). Two-thirds of women (67%) attending standard public antenatal care in regional areas and 61% attending regional Aboriginal Family Birthing Program Services were breastfeeding at 12 weeks, compared to one third of women (36%) attending standard metropolitan public antenatal care and 49% of women attending metropolitan Aboriginal Family Birthing Program Services. Less than half of women (45%) described their postnatal care as 'very good', and 40% were not always able to access support with infant feeding when needed. The most common reasons for switching to formula before 6 weeks were: low milk supply/baby not gaining weight, mastitis/sore breasts or other feeding problems. Mothers also identified their own health as a factor. CONCLUSION: While the findings must be treated with caution due to small numbers, they suggest benefits for women attending Aboriginal Family Birthing Program services in the urban environment where rates of initiation and continued breastfeeding are lowest. Provision of culturally appropriate support to Aboriginal women during and after pregnancy is key to improving outcomes.


Assuntos
Aleitamento Materno/estatística & dados numéricos , Mães/estatística & dados numéricos , Grupo com Ancestrais Oceânicos/estatística & dados numéricos , Fatores de Tempo , Adulto , Peso ao Nascer , Aleitamento Materno/etnologia , Aleitamento Materno/psicologia , Feminino , Humanos , Lactente , Recém-Nascido , Idade Materna , Mães/psicologia , Razão de Chances , Gravidez , Cuidado Pré-Natal/estatística & dados numéricos , Austrália do Sul
17.
J Natl Med Assoc ; 111(2): 153-157, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30177281

RESUMO

OBJECTIVE: Infant feeding practices have been shown to differ between immigrants and non-immigrants in the United States. Our study characterizes feeding practices of infants of immigrant versus American-born mothers followed in an inner city Pediatric continuity clinic serving predominantly low socioeconomic status families. METHODS: A survey was given to 102 parents of infants ranging from 12 to 15 months of age who attended the clinic. Parents were asked about their country of origin, ethnic background and time since immigration to the US. They were also asked about their breastfeeding and early infant feeding practices. Statistical significance was estimated using chi-squared tests. RESULTS: Not only were breastfeeding rates higher among immigrant mothers compared to American-born mothers (88% vs. 63%, p-value 0.008) but they introduced commercially available baby food less frequently (37% vs. 52%, p-value 0.03) and rarely fed their infants fast food (22% vs. 50%, p-value<0.001). Moreover, breast feeding rates decreased with duration of residence in the United States. 53% of immigrant mothers who have been in the United States for less than 5 years breastfed for over 6 months versus 22% of immigrant mothers who resided more than 5 years in the United States (p-value 0.02). The vast majority of immigrant mothers who switched to formula did so because they felt their milk production was insufficient (93%) whereas the vast majority of American-born mothers stopped breastfeeding because they perceived it to be painful (64%, p value 0.001). CONCLUSIONS: Infant feeding practices differ between immigrant and American-born mothers and the differences diminish the longer the mothers reside in the United States. These differences stem from differences in cultural perceptions of breastfeeding. Therefore, in educating mothers about infant feeding, physicians should strongly consider cultural and ethnic factors.


Assuntos
Aleitamento Materno/etnologia , Aleitamento Materno/estatística & dados numéricos , Emigrantes e Imigrantes/estatística & dados numéricos , Fórmulas Infantis/estatística & dados numéricos , Mães/estatística & dados numéricos , População Urbana/estatística & dados numéricos , África/etnologia , Região do Caribe/etnologia , América Central/etnologia , Cultura , Emigração e Imigração , Feminino , Humanos , Lactente , Áreas de Pobreza , América do Sul/etnologia , Inquéritos e Questionários , Fatores de Tempo , Estados Unidos
18.
Birth ; 46(1): 157-165, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-30216531

RESUMO

BACKGROUND: Racial or ethnic and socioeconomic disparities in adverse birth outcomes are well known, but few studies have examined disparities in the receipt of prenatal health education. The objectives of this study were to examine racial or ethnic and socioeconomic variations in receiving (1) comprehensive prenatal health education and (2) education about human immunodeficiency virus (HIV) testing, breastfeeding, alcohol, and smoking cessation from health care practitioners. METHODS: Data were drawn from the 2012 to 2014 Pregnancy Risk Assessment Monitoring System (PRAMS). Twenty-seven states were included with an analysis sample size of 68 025 participants. Receiving counseling on all listed health topics during prenatal care visits was denoted as comprehensive prenatal health education. Logistic regression was used to examine the association of racial or ethnic and socioeconomic variables with receiving comprehensive prenatal health education, and HIV testing, breastfeeding, alcohol, and smoking cessation advice separately. RESULTS: Multivariable results showed that racial or ethnic minorities and women with a high school degree or less; receiving Women, Infant, and Children (WIC) assistance; and on Medicaid during pregnancy have higher odds of receiving comprehensive prenatal health education (all P  ≤0 .001). Results were similar for receiving HIV testing, breastfeeding, alcohol, and smoking counseling. Low household income was associated with receiving counseling on HIV testing, alcohol, and smoking (all P ≤ 0.001). CONCLUSION: Despite reporting higher levels of prenatal health education on a variety of health-related topics, disadvantaged women continue to experience disparities in adverse birth outcomes suggesting that education is insufficient in promoting positive behaviors and birth outcomes.


Assuntos
Aleitamento Materno/etnologia , Comportamentos Relacionados com a Saúde/etnologia , Comportamento Materno/etnologia , Educação Pré-Natal/estatística & dados numéricos , Adolescente , Adulto , Aconselhamento/métodos , Feminino , Humanos , Lactente , Recém-Nascido , Modelos Logísticos , Análise Multivariada , Vigilância da População , Gravidez , Medição de Risco , Fumar/etnologia , Fatores Socioeconômicos , Estados Unidos/etnologia , Adulto Jovem
19.
J Pediatr ; 204: 134-141.e1, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-30274926

RESUMO

OBJECTIVE: To examine the extent to which maternal race/ethnicity is associated with mother's milk use among hospitalized very low birth weight (VLBW) infants and maternal receipt of hospital breastfeeding support practices (human milk prenatal education, first milk expression <6 hours after delivery, lactation consultation <24 hours, any skin-to-skin care <1 month). STUDY DESIGN: We studied 1318 mother-VLBW infant pairs in 9 Massachusetts level 3 neonatal intensive care units (NICUs) between January 2015 and November 2017. We estimated associations of maternal race/ethnicity with any and exclusive mother's milk on day 7, on day 28, and at discharge/transfer and hospital practices. We estimated HRs comparing the probability of continued milk use over the hospitalization by race/ethnicity and tested mediation by hospital practices, adjusting for birth weight and gestational age and including hospital and plurality as random effects. RESULTS: Mothers were 48% non-Hispanic white, 21% non-Hispanic black, and 20% Hispanic. Initiation of mother's milk was similar across groups, but infants of Hispanic mothers (hazard ratio [HR], 2.71; 95% CI, 2.05-3.59) and non-Hispanic black mothers (HR, 1.55; 95% CI, 1.17-2.07) stopped receiving milk earlier in the hospitalization compared with infants of non-Hispanic white mothers. Hispanic mothers had lower odds of providing skin-to-skin care at <1 month (OR, 0.61; 95% CI, 0.43-0.87) compared with non-Hispanic whites. CONCLUSIONS: Hispanic and non-Hispanic black mothers were less likely than non-Hispanic white mothers to continue providing milk for their VLBW infants throughout the NICU stay.


Assuntos
Aleitamento Materno/etnologia , Disparidades em Assistência à Saúde/etnologia , Leite Humano , Aleitamento Materno/estatística & dados numéricos , Grupos Étnicos , Feminino , Humanos , Recém-Nascido , Recém-Nascido de muito Baixo Peso , Unidades de Terapia Intensiva Neonatal , Estimativa de Kaplan-Meier , Masculino , Massachusetts , Mães/estatística & dados numéricos , Alta do Paciente , Padrões de Prática Médica/estatística & dados numéricos
20.
Midwifery ; 69: 67-75, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30399510

RESUMO

OBJECTIVE: To assess the role of the mother's mother and mothers' previous personal experiences with breastfeeding and childcare in breastfeeding practices. DESIGN AND SETTING: The analysis included 13,774 mother-infant dyads from the French national birth cohort ELFE. Feeding practices were assessed by face-to-face interview in maternity wards in 2011, by phone interviews at months 2 and 12 post-partum and by Internet/paper questionnaires monthly from months 3-10. Sociodemographic, maternal and newborn-related factors were collected in the maternity unit and by postnatal phone interview at month 2. Multivariable logistic and linear regression was used to assess the association of mother's mother and mothers' previous personal experiences with breastfeeding initiation and duration. FINDINGS: Previous breastfeeding experience (i.e., whether mothers had breastfed their previous children) was positively associated with both breastfeeding initiation and duration. Mothers who had been breastfed themselves as infants were more likely to initiate and continue breastfeeding than non-breastfed mothers. Conversely, non-breastfed mothers who had received care advice from their own mother were less likely to start and maintain breastfeeding. The effect of having been breastfed in infancy was especially important for primiparous mothers and to a lesser extent, multiparous mothers with no previous breastfeeding experience. Also, formal experience in childcare, in a professional context, was associated with breastfeeding initiation but not duration. KEY CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: Mother's mother and mother's previous breastfeeding experience have a strong influence on breastfeeding practices. Breastfeeding interventions should be tailored to the mother's level of experience and should provide extra support for multiparous mothers with no previous breastfeeding experience.


Assuntos
Aleitamento Materno/psicologia , Relação entre Gerações/etnologia , Mães/psicologia , Fatores de Tempo , Adulto , Atitude Frente a Saúde/etnologia , Aleitamento Materno/etnologia , Aleitamento Materno/métodos , Comportamento de Escolha , Estudos de Coortes , Feminino , França/etnologia , Avós/psicologia , Humanos , Modelos Logísticos , Período Pós-Parto/psicologia , Fatores Socioeconômicos , Inquéritos e Questionários
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA