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1.
South Med J ; 114(4): 223-230, 2021 04.
Artigo em Inglês | MEDLINE | ID: mdl-33787936

RESUMO

OBJECTIVES: The purpose of this study was to investigate and identify which sociodemographic factors may be associated with breastfeeding intention and breastfeeding self-efficacy among pregnant women. METHODS: Pregnant women at a medical center in Alabama completed a cross-sectional survey. The Prenatal Rating of Efficacy in Preparation to Breastfeed Scale (PREP to BF) was used to assess prenatal breastfeeding self-efficacy. A valid 3-item breastfeeding intention scale and the Fetal Health Locus of Control Scale also were used. Nonparametric tests were used to assess differences in breastfeeding intention, locus of control subscales, and PREP to BF scores by history with breastfeeding, planned mode of delivery, and sociodemographic factors. RESULTS: The participants in the final analysis (N = 124) had a mean prenatal breastfeeding self-efficacy score of 299.5 (±92.33), with a range of 0 to 390. Significantly lower scores related to intention and PREP to BF were found among Black women (P ≤ 0.05), those with a high school education or less (P ≤ 0.019), single women (P ≤ 0.028), and those who had no breastfeeding experience (P ≤ 0.035). CONCLUSIONS: Identifying pregnant women with low breastfeeding self-efficacy and intention and recognizing the effects of social and cultural influences on breastfeeding are vital. Healthcare providers can engage in meaningful dialog to address ways to increase social support, communication, goal-setting skills, and overcoming mental and emotional barriers.


Assuntos
Aleitamento Materno/psicologia , Intenção , Gestantes/psicologia , Relações Profissional-Paciente , Autoeficácia , Adolescente , Adulto , Alabama , Aleitamento Materno/etnologia , Estudos Transversais , Feminino , Humanos , Controle Interno-Externo , Gravidez , Gestantes/etnologia , Autorrelato , Fatores Socioeconômicos , Adulto Jovem
2.
Obstet Gynecol ; 137(2): e54-e62, 2021 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-33481532

RESUMO

ABSTRACT: Breastfeeding has maternal, infant, and societal benefits. However, many parents experience obstacles to achieving their breastfeeding goals, leading to reduced rates of breastfeeding initiation and continuation. Despite efforts to increase rates of breastfeeding initiation and continuation, inequities still persist. The factors that influence an individual's desire and ability to breastfeed are varied and include individual parent considerations; practitioner influences; hospital barriers; societal factors, such as workplace and parental leave policies; access to lactation support; and social support of their breastfeeding goals. A multidisciplinary approach that involves community, family, parents, and health care professionals will strengthen the support for parents and help them achieve their breastfeeding goals.


Assuntos
Aleitamento Materno/psicologia , Cuidado Pós-Natal , Aleitamento Materno/etnologia , Feminino , Humanos , Recém-Nascido , Gravidez
3.
Medicine (Baltimore) ; 99(28): e20815, 2020 Jul 10.
Artigo em Inglês | MEDLINE | ID: mdl-32664074

RESUMO

BACKGROUND: The high rate of cesarean section is an important factor affecting breastfeeding in China. To improve the nation's current situation of breastfeeding, promoting breastfeeding in women undergoing cesarean section is essential. OBJECTIVE: To explore the effects of health belief model-based interventions on breastfeeding knowledge, breastfeeding behaviors, and breastfeeding satisfaction of Chinese cesarean women. METHODS: A total of 346 cesarean section women were enrolled in the randomized controlled trial conducted at a center in Chengdu, China, between July 1, 2018 and August 31, 2018. While the control group (n = 173) received conventional breastfeeding guidance only, the intervention group (n = 173) received additional interventions based on the health belief model. Questionnaires were distributed to assess breastfeeding knowledge, breastfeeding behavior, and breastfeeding satisfaction at discharge, 42 days postpartum, and 4 months postpartum, respectively. RESULTS: At discharge from hospital, the breastfeeding knowledge score of the intervention group was higher than that of the control group (Z = -11.753, P < .001). The exclusive breastfeeding rates in the intervention group at the time of discharge, 42 days postpartum, and 4 months postpartum were 67.3%, 60.7%, and 52.9%, respectively, while those of the control group were 41.2%, 41.6%, and 40.4%, respectively. The differences were statistically significant (χ = 23.353, P < .001; χ = 11.853, P < .001; χ = 4.805, P = .03). The breastfeeding satisfaction of the intervention group was also higher than the control group at the time of discharge, 42 days postpartum and 4 months postpartum (t = 4.955, P < .001; t = 3.051, P = .002; Z = -3.801, P < .001). CONCLUSION: The health belief model-based interventions can effectively increase breastfeeding knowledge for Chinese cesarean women and improve their breastfeeding behaviors and breastfeeding satisfaction within 4 months after delivery. CLINICAL TRIAL REGISTRATION: ChiCTR1900026006 .


Assuntos
Aleitamento Materno/psicologia , Cesárea/efeitos adversos , Conhecimentos, Atitudes e Prática em Saúde/etnologia , Adulto , Aleitamento Materno/etnologia , Aleitamento Materno/estatística & dados numéricos , Cesárea/estatística & dados numéricos , China/etnologia , Cultura , Feminino , Humanos , Alta do Paciente/estatística & dados numéricos , Alta do Paciente/tendências , Satisfação do Paciente/etnologia , Satisfação do Paciente/estatística & dados numéricos , Período Pós-Parto/fisiologia , Gravidez , Estudos Prospectivos , Inquéritos e Questionários
4.
PLoS One ; 15(4): e0232316, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32353021

RESUMO

BACKGROUND: Studies in sub-Saharan Africa indicated the overall prevalence of optimal breast feeding ranged between a lowest of 17.63% in East Africa and a highest of 46.37% in West Africa. It's estimated that 823,000 deaths of children could be prevented every year through optimal breastfeeding practices. However optimal breastfeeding practices is low in most setting of Ethiopia. Therefore, this study aimed to assess optimal breastfeeding practices and associated factors in Worabe town. METHOD: A community-based analytical cross-sectional study was conducted from April 15th-25th, 2018. A systematic sampling technique was applied on 347 sampled mothers who had children greater than or equal to 2 years old. The data was entered into EpiData (version 3.1) and subsequently exported to SPSS Statistics (version 22) for analysis. Descriptive statistics were used for presenting summary data using tables and graph. Bivariate and multi variable logistic regression analysis to identify were used to identify associated factors. The statistical significance was declared at P<0.05. RESULT: Optimal breastfeeding was exhibited by 42.1% of mothers. Government employees (AOR = 8.0; 95% CI: 1.7, 36.4), families with a household income of 1,500-3,000 Ethiopian birr (AOR = 4.6; 95% CI: 1.0, 20.1), individuals knowledgeable about optimal breastfeeding practices (AOR: 5.5 95% CI: 1.6, 18.1), individuals counselled about breastfeeding practices during postnatal follow-ups (AOR = 4.940, 95% CI: 1.313, 10.195), and individuals that had a caesarean section delivery (AOR = 4.2, 95% CI: 1.2, 14.1) had a higher chance of practicing optimal breastfeeding. However, mothers who did not attend or have access to antenatal care follow-ups (AOR = 0.1, 95% CI: 0.04, 0.5) were less likely to practice optimal breastfeeding. CONCLUSIONS: Less than half of mothers breastfed their children optimally. Factors that influenced this included knowledge of optimal breastfeeding practices, total household income, the woman's occupation, access to breastfeeding counselling during postnatal care follow-ups, access to antenatal care follow-ups, and mode of delivery. It is strongly recommended that optimal breastfeeding awareness programs through health education be done in collaboration with health extension workers, and zonal health offices.


Assuntos
Aleitamento Materno/estatística & dados numéricos , Modelos Estatísticos , Guias de Prática Clínica como Assunto , Adolescente , Adulto , Atitude Frente a Saúde , Aleitamento Materno/economia , Aleitamento Materno/etnologia , Cesárea/estatística & dados numéricos , Etiópia , Utilização de Instalações e Serviços/estatística & dados numéricos , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Cuidado Pós-Natal/estatística & dados numéricos , Cuidado Pré-Natal/estatística & dados numéricos , Educação Pré-Natal/estatística & dados numéricos , Fatores Socioeconômicos
5.
Pediatrics ; 145(4)2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-32188643

RESUMO

BACKGROUND: Mexican-origin women breastfeed at similar rates as white women in the United States, yet they usually breastfeed for less time. In our study, we seek to identify differences in Mexican-origin women's breastfeeding intentions, initiation, continuation, and supplementation across nativity and country-of-education groups. METHODS: The data are from a prospective cohort study of postpartum women ages 18 to 44 recruited from 8 Texas hospitals. We included 1235 Mexican-origin women who were born and educated in either Texas or Mexico. Women were interviewed at delivery and at 3, 6, 12, 18, and 24 months post partum. Breastfeeding intentions and initiation were reported at baseline, continuation was collected at each interview, and weeks until supplementation was assessed for both solids and formula. Women were classified into 3 categories: born and educated in Mexico, born and educated in the United States, and born in Mexico and educated in the United States. RESULTS: Breastfeeding initiation and continuation varied by nativity and country of birth, although all women reported similar breastfeeding intentions. Women born and educated in Mexico initiated and continued breastfeeding in higher proportions than women born and educated in the United States. Mexican-born and US-educated women formed an intermediate group. Early supplementation with formula and solid foods was similar across groups, and early supplementation with formula negatively impacted duration across all groups. CONCLUSIONS: Nativity and country of education are important predictors of breastfeeding and should be assessed in pediatric and postpartum settings to tailor breastfeeding support. Support is especially warranted among US-born women, and additional educational interventions should be developed to forestall early supplementation with formula across all acculturation groups.


Assuntos
Aleitamento Materno/etnologia , Aculturação , Adulto , Aleitamento Materno/psicologia , Aleitamento Materno/estatística & dados numéricos , Suplementos Nutricionais/estatística & dados numéricos , Escolaridade , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Hispano-Americanos/estatística & dados numéricos , Humanos , Fórmulas Infantis/estatística & dados numéricos , Recém-Nascido , Intenção , México/etnologia , Mães/educação , Estudos Prospectivos , Texas , Fatores de Tempo , Estados Unidos
6.
Hum Nat ; 31(1): 43-67, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31898017

RESUMO

Variation in the durations of exclusive breastfeeding (exBF) and any breastfeeding (anyBF) is associated with socioecological factors. This plasticity in breastfeeding behavior appears adaptive, but the mechanisms involved are unclear. With this concept in mind, we investigated whether durations of exBF and anyBF in a rural Maya population covary with markers of a form of socioecological change-market integration-and whether individual factors (individual learning, physiological plasticity) and/or learning from others in the community (social learning, norm adherence) mediate these changes. Using data from 419 mother-child pairs from two Guatemalan Maya villages, we fit a bivariate linear mixed model. The model compared exBF and anyBF among children from households of varying degrees of market integration whose mothers follow what we inferred to be local infant-feeding norms. It controlled for other factors expected to affect breastfeeding durations. We found evidence that exBF is associated with whether mothers follow their population's infant feeding norms, but no evidence that exBF is associated with the household's level of market integration. Conversely, anyBF is significantly associated with the household's market integration, but not with the villages' inferred norms. Because deviations from exBF norms are likely to result in infant mortality and reduced fitness, we hypothesize that the incentive to conform is relatively strong. Relatively greater individual plasticity in anyBF allows mother-child pairs to tailor it to socioecological conditions. Deviations from anyBF norms may be tolerated because they may provide later-life health/fitness payoffs, while posing few risks to infant survival.


Assuntos
Aleitamento Materno/etnologia , Conhecimentos, Atitudes e Prática em Saúde/etnologia , Mães , Aprendizado Social , Adulto , Feminino , Guatemala/etnologia , Humanos , Lactente , Fatores de Tempo
7.
BMC Pregnancy Childbirth ; 20(1): 51, 2020 Jan 23.
Artigo em Inglês | MEDLINE | ID: mdl-31973693

RESUMO

BACKGROUND: Migration to another country has a potential influence on breastfeeding practices. A significant difference in breastfeeding rates between Irish nationals and non-nationals has been reported. This study was conducted to explore breastfeeding practices of the Chinese in Ireland, one of the largest Irish ethnic groups, and to explore the influence of living in Ireland on breastfeeding practices. This is the first and the only migration study so far on breastfeeding practices among the Chinese in Ireland. METHODS: A sequential explanatory mixed methods approach was adopted. The first phase was a cross-sectional self-administered retrospective mailed survey, to explore breastfeeding practices and determinants of breastfeeding among a convenience sample of Chinese mothers living in Ireland (n = 322). Recruitment was conducted in the Dublin metropolitan area, with the application of the snowball technique to increase sample size. The second phase consisted of seven semi-structured focus groups (n = 33) conducted in Dublin, to explore the influence of living in Ireland on breastfeeding among Chinese mothers who had given birth in Ireland. Quantitative data were analyzed by univariate and multivariate logistic regression analyses, and informed the qualitative data collection. Qualitative data were analyzed by thematic content analyses, to explain and enrich the qualitative results. RESULTS: The breastfeeding initiation rate among Chinese immigrants to Ireland who gave birth in Ireland (CMI) (75.6%) was high and close to that of Chinese immigrant mothers who gave birth in China (CMC) (87.2%). However, giving birth in Ireland was independently associated with a shorter duration of breastfeeding (< 4 months) among Chinese immigrants. Qualitative results explained that a shorter breastfeeding duration among CMI than that of CMC was mainly due to cultural conflicts, a lack of family support, language barriers, immigrants' low socioeconomic status, and mothers' preference for infant formula on the Irish market. Both quantitative and qualitative data revealed a strong cultural belief in the efficacy of the traditional Chinese postpartum diet for breast milk production for both CMC and CMI. Antenatal feeding intention was a strong determinant for breastfeeding initiation and duration among CMI. CONCLUSION: Migration to Ireland was found to be associated with a shorter duration of breastfeeding of the Chinese. Culturally sensitive and language-specific education and support of breastfeeding is needed for the Chinese mothers living in Ireland. The mixed methods design presented here might serve as a template for future migration research on breastfeeding.


Assuntos
Grupo com Ancestrais do Continente Asiático/psicologia , Atitude Frente a Saúde/etnologia , Aleitamento Materno/etnologia , Desmame/etnologia , Adulto , China/etnologia , Estudos Transversais , Emigrantes e Imigrantes/estatística & dados numéricos , Feminino , Promoção da Saúde , Humanos , Lactente , Cuidado do Lactente/métodos , Irlanda , Relações Mãe-Filho/etnologia , Mães , Fatores Socioeconômicos
8.
J Pediatr ; 218: 49-56.e3, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-31843218

RESUMO

OBJECTIVES: To examine how infant and maternal factors, hospital factors, and neighborhood-level factors impact or modify racial/ethnic disparities in human milk intake at hospital discharge among very low birth weight infants. STUDY DESIGN: We studied 14 422 infants from 119 California Perinatal Quality Care Collaborative neonatal intensive care units born from 2008 to 2011. Maternal addresses were linked to 2010 census tract data, representing neighborhoods. We tested for associations with receiving no human milk at discharge, using multilevel cross-classified models. RESULTS: Compared with non-Hispanic whites, the adjusted odds of no human milk at discharge was higher among non-Hispanic blacks (aOR 1.33 [1.16-1.53]) and lower among Hispanics (aOR 0.83 [0.74-0.93]). Compared with infants of more educated white mothers, infants of less educated white, black, and Asian mothers had higher odds of no human milk at discharge, and infants of Hispanic mothers of all educational levels had similar odds as infants of more educated white mothers. Country of birth and neighborhood socioeconomic was also associated with disparities in human milk intake at discharge. CONCLUSIONS: Non-Hispanic blacks had the highest and Hispanic infants the lowest odds of no human milk at discharge. Maternal education and country of birth were the biggest drivers of disparities in human milk intake, suggesting the need for targeted approaches of breastfeeding support.


Assuntos
Aleitamento Materno/etnologia , Grupos de Populações Continentais , Grupos Étnicos , Recém-Nascido de muito Baixo Peso , Unidades de Terapia Intensiva Neonatal/estatística & dados numéricos , Leite Humano , Adulto , California/epidemiologia , Feminino , Humanos , Recém-Nascido , Masculino , Alta do Paciente/tendências , Gravidez , Estudos Retrospectivos
9.
Women Birth ; 33(4): e391-e399, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31353232

RESUMO

BACKGROUND: Culturally sensitive care in the health care system is imperative for optimal outcomes of all patients, especially women and their infants. For Arabic mothers in Australia, there is minimal research exploring their beliefs that could impact on their infant feeding decisions and practices. AIM: The aim of this study was to explore the experiences, knowledge and influences around infant feeding in Arabic women in Australia. METHOD: A qualitative descriptive approach was used. Focus groups were conducted with Arabic women in community organisations (Catholic & Islamic) in Sydney. A thematic analysis was undertaken. The Iowa Infant Feeding Attitude Scale (IIFAS) was also used to measure maternal attitudes towards infant feeding. FINDINGS: A total of 17 women participated in three focus groups. Themes relating to infant feeding were identified, including (1) sources of knowledge and education, particularly, where mothers obtained their infant feeding knowledge, and how this was influenced; (2) cultural beliefs related to the support and direction of family members.; (3) religious beliefs surrounding the continuation of infant feeding practices; (4) social and personal themes as an influence on infant feeding decisions and practices, and (5) factors associated with cessation of exclusive breastfeeding, including the lack of support from health care professionals. CONCLUSION: The Arabic women in this study have expressed their need for further culturally sensitive care surrounding infant feeding knowledge and practices, and for that care to be situated in their community. Further intervention-based studies in the community focusing on culturally competent and sensitive care are recommended.


Assuntos
Árabes/psicologia , Comportamento Alimentar/etnologia , Conhecimentos, Atitudes e Prática em Saúde/etnologia , Cuidado do Lactente/estatística & dados numéricos , Mães/psicologia , Adulto , Austrália , Aleitamento Materno/etnologia , Criança , Competência Cultural/psicologia , Assistência à Saúde Culturalmente Competente/etnologia , Feminino , Grupos Focais , Humanos , Lactente , Recém-Nascido , Pesquisa Qualitativa
10.
Women Birth ; 33(4): e377-e384, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31337586

RESUMO

PROBLEM: In Bhutan, exclusive breastfeeding is not routinely practised according to the World Health Organisation recommendation, thereby placing infants and women at increased risk of morbidity and mortality. BACKGROUND: Research indicates that support from midwives is positively associated with longer breastfeeding duration. Previously, no studies had been conducted in Bhutan to explore midwives' perceptions of the barriers to the promotion of exclusive breastfeeding. AIM: To explore midwives' perceptions of the barriers to promoting exclusive breastfeeding among Bhutanese women. METHODS: A qualitative exploratory descriptive study design was used, involving individual semi-structured audio-recorded interviews. The Framework approach was utilised for data analysis. FINDINGS: Five themes emerged from a total of 26 interviews. The themes were: 'cultural and traditional practices', 'women's return to work', 'midwives' advice in response to breastfeeding problems', 'shortage of staff in a busy maternity service' and 'lack of professional development about breastfeeding'. DISCUSSION: Midwives reported that upholding Bhutanese cultural and traditional practices by women and their families was a powerful barrier to the promotion of exclusive breastfeeding. Midwives experienced difficulty in promoting exclusive breastfeeding among women in the immediate postnatal period during women's short hospital stay. A shortage of midwives, coupled with a lack of professional development about breastfeeding promotion and support, were additional barriers to the promotion of exclusive breastfeeding. CONCLUSION: The study findings highlight the need for continuing professional development of midwives in relation to exclusive breastfeeding. Additionally, a review of the midwifery workforce model is recommended, to ensure midwives have time to provide women with breastfeeding support.


Assuntos
Aleitamento Materno/etnologia , Características Culturais , Comportamento Materno/etnologia , Enfermeiras Obstétricas/psicologia , Adulto , Butão , Aleitamento Materno/psicologia , Feminino , Hospitais , Humanos , Lactente , Entrevistas como Assunto , Tocologia , Cuidado Pós-Natal , Gravidez , Pesquisa Qualitativa
11.
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
12.
Nutrients ; 11(11)2019 Nov 18.
Artigo em Inglês | MEDLINE | ID: mdl-31752094

RESUMO

An unresolved question about breastfeeding is its effect on caries, in particular, early childhood caries (ECC). In secondary analyses of data from an ECC intervention, we describe breastfeeding among Aboriginal children and associations between breastfeeding and ECC. Breastfeeding (duration and exclusivity to six months) was grouped into mutually exclusive categories. ECC was observed by a calibrated dental professional. Outcomes were prevalence of ECC (% decayed, missing, and filled teeth in the primary dentition (% dmft>0)) and caries severity (mean number of decayed, missing, and filled surfaces (mean dmfs)) in children aged three years. Analyses were adjusted for confounding. Multiple imputation was undertaken for missing information. Of 307 participants, 29.3% were never breastfed, 17.9% exclusively breastfed to six months, and 9.3% breastfed >24 months. Breastfeeding >24 months was associated with higher caries prevalence (adjusted prevalence ratio (PRa) 2.06 (95%CI 1.35, 3.13, p-value = 0.001) and mean dmfs (5.22 (95% CI 2.06, 8.38, p-value = 0.001), compared with children never breastfed. Exclusive breastfeeding to six months with breastfeeding <24 months was associated with 1.45 higher caries prevalence (95% CI -0.92, 2.30, p-value = 0.114) and mean dmfs 2.04 (-0.62, 4.71, p-value = 0.132), compared with never breastfeeding. The findings are similar to observational studies on breastfeeding and caries but not with randomized controlled trials of breastfeeding interventions. Despite attending to potential biases, inconsistencies with trial evidence raises concerns about the ability to identify causal effects of breastfeeding in observational research.


Assuntos
Aleitamento Materno/efeitos adversos , Cárie Dentária/etnologia , Cárie Dentária/etiologia , Austrália/epidemiologia , Viés , Aleitamento Materno/etnologia , Causalidade , Pré-Escolar , Fatores de Confusão Epidemiológicos , Feminino , Humanos , Masculino , Grupo com Ancestrais Oceânicos , Gravidez , Prevalência
13.
Soc Sci Med ; 242: 112565, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31627080

RESUMO

Guatemala has the fourth highest infant mortality rate in Latin America, which makes the support and protection of breastfeeding especially critical. Traditional health-promoting practices like breastfeeding may be protected by increasing knowledge of its benefits. Yet there is a dearth of research documenting breastfeeding knowledge (i.e., knowledge of its benefits for infant health and development) in communities where breastfeeding is already practiced. OBJECTIVE: Our aim was to assess degree of breastfeeding knowledge among Mayan mothers in the rural highlands of North-Western Guatemala and compare knowledge of breastfeeding - a practice promoted by local health centers - and other traditional yet non-promoted infant care practices. METHOD: We conducted a survey of maternal-infant health knowledge and behavior among mothers in rural Guatemala (N = 300) from six communities with a non-governmental organization (NGO) health program and one comparison community. RESULTS: Overall, mothers displayed more knowledge of the benefits of breastfeeding in comparison with other traditional infant care practices not promoted by a community health program. Mothers in communities with a health program demonstrated increased knowledge of breastfeeding, regardless of whether they personally participated in the program. This health knowledge predicted participation in novel health-promoting behaviors (family planning, prenatal care, exclusive breastfeeding). CONCLUSIONS: Understanding breastfeeding knowledge as a proxy for community health exposure may increase the efficacy and diffusion of community health messaging.


Assuntos
Aleitamento Materno/psicologia , Conhecimentos, Atitudes e Prática em Saúde , Mães/psicologia , População Rural/tendências , Adulto , Aleitamento Materno/etnologia , Feminino , Guatemala/etnologia , Humanos , Lactente , Recém-Nascido , Mães/estatística & dados numéricos , Gravidez , Inquéritos e Questionários
14.
J Midwifery Womens Health ; 64(6): 743-748, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31625682

RESUMO

INTRODUCTION: The Ten Steps to Successful Breastfeeding are evidence-based practices used to improve breastfeeding outcomes, and most are to be implemented shortly after birth. Although breastfeeding is increasing in the United States, racial disparities persist. Available national samples used to examine trends in maternity care rely on maternal recall, which may be subject to error and bias. Thus, we conducted a pilot study to determine the feasibility of a large-scale study conducted during the birth hospitalization to explore patterns in practices supporting breastfeeding across maternal racial and ethnic groups. METHODS: A convenience sample of 37 women with healthy, term singletons who intended to breastfeed were recruited from 2 academic medical centers (one in the Midwest and the other in the Pacific Northeast) and surveyed during their birth hospitalizations between July and November 2016. Women were asked whether they received the 7 steps that are recommended to be implemented shortly after birth (eg, encourage breastfeeding on demand). We generated descriptive statistics and conducted independent chi-square tests to determine associations between self-reported exposure to these 7 practices and race and ethnicity. RESULTS: In this sample, 23 women (62.2%) were non-Hispanic white, 5 (13.5%) were non-Hispanic black, and 6 (16.2%) were Hispanic. Approximately 26 (70.3%) reported experiencing at least 6 of the 7 practices. Non-Hispanic white women were significantly more likely to room-in with their newborns, were less likely to receive formula, and were less likely to receive pacifiers than women of other races and ethnicities (P < .05). Furthermore, differences in exposure to practices by maternal race/ethnicity appeared more pronounced at one center than the other. DISCUSSION: Preliminary findings suggest that some practices used to improve breastfeeding may be provided inconsistently across maternal racial and ethnic groups. Additional investigation is needed to further explore these patterns and to identify reasons for any inconsistencies in order to reduce health disparities in the United States.


Assuntos
Afro-Americanos/psicologia , Aleitamento Materno/etnologia , Grupos de Populações Continentais/psicologia , Hispano-Americanos/psicologia , Comportamento Materno/etnologia , Mães/psicologia , Adulto , Feminino , Comportamentos Relacionados com a Saúde/etnologia , Humanos , Cuidado do Lactente/psicologia , Recém-Nascido , Mães/educação , Projetos Piloto , Cuidado Pós-Natal/métodos , Estados Unidos
15.
Breastfeed Med ; 14(10): 724-730, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31657635

RESUMO

Purpose: To test the feasibility and possible effects of two iPad®-based breastfeeding interventions for expectant minority women and evaluate (1) the intervention effect on exclusive breastfeeding (EBF) intention, (2) intervention acceptability and satisfaction, and (3) follow-up rates of in-hospital EBF. Materials and Methods: This was a longitudinal survey study with follow-up chart review. Expectant women who completed clinically required breastfeeding education were eligible and were assigned to one of the following interventions by nonrandomized block design: the champion intervention utilized a free commercially available app to identify a supportive breastfeeding champion and the positive messaging intervention offered breastfeeding information in a question-answer format. Medical records were reviewed postpartum for in-hospital feeding choice. Data were analyzed using percentages, frequencies, chi-squared analyses, and McNemar's test. Results: We enrolled 243 publicly insured predominantly African American women: 132 and 111 completed the champion and positive messaging interventions, respectively. Thirty-two of 40 champion participants (80.03%) intended EBF and did in-hospital EBF; 39/86 champion participants (45.3%) not intending EBF did in-hospital EBF (p < 0.0001 for change). Similarly, 30/36 positive messaging participants (83.3%) intended EBF and did in-hospital EBF; 36/67 positive messaging participants (53.7%) not intending EBF did in-hospital EBF (p < 0.0001 for change). Conclusions: In this pilot of two brief, iPad-based prenatal interventions designed to promote in-hospital EBF among minority women, interventions were feasible and a statistically significant change in the proportion of women who intended (prenatally) and then chose (postpartum) EBF was noted. Additional controlled trials are needed to demonstrate the effectiveness of this approach.


Assuntos
Aleitamento Materno , Comportamento Materno/psicologia , Aplicativos Móveis , Gestantes , Educação Pré-Natal/métodos , Adulto , Afro-Americanos , Aleitamento Materno/etnologia , Aleitamento Materno/métodos , Aleitamento Materno/psicologia , Estudos de Viabilidade , Feminino , Comportamentos Relacionados com a Saúde , Humanos , Intenção , Estudos Longitudinais , Ohio , Gravidez , Gestantes/etnologia , Gestantes/psicologia , Avaliação de Programas e Projetos de Saúde
16.
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 Físico/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
17.
J Pediatr Health Care ; 33(6): e46-e56, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31655788

RESUMO

INTRODUCTION: Formula supplementation among infants of breastfeeding Hispanic immigrants is common practice known as las dos cosas. The purpose of this study was to assess the feasibility, effectiveness, and acceptability of a culturally and linguistically diverse intervention to promote exclusive breastfeeding (EBF) for the first 6 months. METHODS: A sample of 39 Hispanic pregnant women was recruited and randomly assigned to intervention (n = 20) and control groups (n = 19). The intervention included a peer counselor and professional support, and mothers were followed from pregnancy to 6 months after birth. RESULTS: After the study, women assigned to the intervention group were over three times more likely to EBF their baby through all four postpartum assessed time points (odds ratio = 3.1, 95% confidence interval: 1.1-8.7). DISCUSSION: This culturally and linguistically diverse intervention contributed to increased EBF duration and decreased formula supplementation in Hispanic mothers up to 6 months postpartum.


Assuntos
Aleitamento Materno/etnologia , Aconselhamento , Fórmulas Infantis , Mães/psicologia , Adulto , Feminino , Hispano-Americanos , Humanos , Lactente , Recém-Nascido , Kentucky , Gravidez
18.
J Midwifery Womens Health ; 64(6): 725-733, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31469235

RESUMO

INTRODUCTION: Breastfeeding rates among women participating in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) are lower compared with those of nonparticipants. The objective of this study was to assess racial and ethnic differences in self-reported reasons for breastfeeding cessation during the first year postpartum. METHODS: This was a secondary analysis of data from women participating in the WIC Infant and Toddler Feeding Practices Study-2. Women specified reasons that influenced their decision to stop breastfeeding during telephone interviews between 1 and 13 months postpartum. Logistic regression models for each racial and ethnic group explored the effects of sociodemographic variables on each reason. RESULTS: The sample for this analysis included 4095 women (34.1% non-Hispanic white, 25.5% non-Hispanic black, and 40.4% Hispanic). Across all race and ethnic groups, food security status was a predictor of some but not all reasons for breastfeeding cessation. Compared with their counterparts who were food secure, white women with low food security and black women with very low food security were more likely (odds ratio [OR], 1.86; 95% CI, 1.04-3.35 and OR, 1.86; 95% CI, 1.19-2.90, respectively) to stop breastfeeding because they wanted or needed someone else to feed their infants. Hispanic women with very low food security were more likely to stop breastfeeding because they felt they did not have enough milk. Compared with their multiparous counterparts, primiparous black and white women were almost twice as likely to stop breastfeeding because of trouble sucking or latching. Hispanic and black women born outside the United States had significantly higher odds of breastfeeding cessation because of the infant losing interest compared with US-born women. Education and marital status significantly predicted reasons for breastfeeding cessation among Hispanic and white women. DISCUSSION: Among women participating in WIC, food security, parity, country of birth, education, and marital status were significant predictors of reasons for breastfeeding cessation across racial and /ethnic groups. Incorporating these findings in education, counseling, and interventions may help overcome breastfeeding barriers.


Assuntos
Aleitamento Materno/etnologia , Grupos Étnicos/estatística & dados numéricos , Disparidades em Assistência à Saúde/etnologia , Comportamento Materno/etnologia , Serviços de Saúde Materna/organização & administração , Relações Mãe-Filho/etnologia , Adulto , Atitude Frente a Saúde , Feminino , Comportamentos Relacionados com a Saúde/etnologia , Disparidades nos Níveis de Saúde , Humanos , Lactente , Recém-Nascido , Estados Unidos
19.
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
20.
Breastfeed Med ; 14(9): 630-639, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31364862

RESUMO

Introduction: The health benefits of breastfeeding for both the mother and her offspring are well established, and breastfeeding may be especially important for mitigating negative health effects of pregnancy complicated by diabetes. Objective: This study sought to examine the association between race/ethnicity, maternal diabetes, and breastfeeding initiation in South Carolina (SC). Materials and Methods: Our study population is comprised of all live, singleton, full-term births in SC delivered January 2004 to December 2016 (292,468 non-Hispanic Whites, 173,158 non-Hispanic Blacks, and 52,174 Hispanics). Generalized estimating equations and an interaction term between race/ethnicity and maternal diabetes status were used to estimate the race/ethnic-specific odds ratio (OR) and 95% confidence intervals (CIs) that a mother with diabetes versus without diabetes initiated breastfeeding. Models were adjusted for maternal and infant sociodemographics (Model 1), additionally for clinical variables and birth outcomes (Model 2), and also for maternal prepregnancy body mass index (BMI) (Model 3). Results: We found statistically significant differences in breastfeeding initiation by race/ethnicity and diabetes status in Model 1. These associations were attenuated and lost significance upon additional adjustment. Non-Hispanic Black mothers with gestational diabetes were significantly more likely to initiate breastfeeding than nondiabetic non-Hispanic Black mothers, even after adjustment for prepregnancy BMI (OR: 1.07 [95% CI 1.02-1.12]). Conclusion: This large, population-based study of all live, singleton, full-term births in SC improves our understanding of how race/ethnicity and maternal metabolic disorders impact breastfeeding initiation, and may inform future hospital-based breastfeeding interventions in populations with the most need.


Assuntos
Aleitamento Materno/etnologia , Aleitamento Materno/estatística & dados numéricos , Diabetes Mellitus/etnologia , Diabetes Gestacional/etnologia , Adulto , Grupo com Ancestrais do Continente Africano , Índice de Massa Corporal , Grupo com Ancestrais do Continente Europeu , Feminino , Hispano-Americanos , Humanos , Lactente , Razão de Chances , Gravidez , Gravidez em Diabéticas , Estudos Retrospectivos , Fatores Socioeconômicos , South Carolina , Nascimento a Termo , Adulto Jovem
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