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To explore how sources of familial encouragement are associated with breast-feeding initiation and duration among a national sample participating in the US Special Supplemental Nutrition Program for Women, Infants, and Children (WIC).
Design:
This study uses the 2013–2015 WIC Infant and Toddler Feeding Practices Study 2 (WIC ITFPS-2) data. Breast-feeding initiation was measured at the first month, while duration was derived from a composite of the first 13 months. The analysis used logistic and linear regression to explore the association between encouragement sources and breast-feeding outcomes.
Setting:
A nationally representative sample of WIC participants in the USA.
Participants:
WIC participants who completed the 13-month interview of the WIC ITFPS-2 (n 2807).
Results:
Encouragement was significantly associated with both initiation and duration. Each source of encouragement was associated with a 3·2 (95 % CI 2·8, 3·8) increase in odds of initiating breast-feeding in the unadjusted model and 3·0 (95 % CI 2·5, 3·6) increased odds, controlling for age, education, nativity, poverty status, race and ethnicity (<0·0001). When predicting log duration, each percent increase in source of encouragement was associated with an increasing duration on average by 0·003 d (95 % CI 0·2, 0·3, <0·0001). When controls were added, it was associated with an increase of an average of 0·002 d (95 % CI 0·2, 0·3) per percent increase in encouragement source (<0·0001).
Conclusions:
Women who receive encouragement appear to be more likely to breastfeed. Additional work is needed to explore sources of encouragement and how to include them in intervention work.
To assess relationships between breast-feeding, rapid growth in the first year of life and overweight/obesity status at the age of 2 years.
Design:
As part of an observational, longitudinal study beginning in early pregnancy, multivariable logistic regressions were used to assess associations between breast-feeding duration (total and exclusive) and rapid weight gain (RWG) between birth and 1 year of age, and to determine predictors of overweight/obesity status at the age of 2 years.
Setting:
Nine hospitals located in the province of Quebec, Canada.
Participants:
A sample of 1599 term infants who participated in the 3D Cohort Study.
Results:
Children having RWG in the first year and those having excess weight at the age of 2 years accounted for 28 % and < 10 %, respectively. In multivariable models, children breastfed < 6 months and from 6 months to < 1 year were, respectively, 2·5 times (OR 2·45; 95 % CI 1·76, 3·41) and 1·8 times (OR 1·78; 95 % CI 1·29, 2·45) more likely to show RWG up to 1 year of age compared to children breastfed ≥ 1 year. Children exclusively breastfed < 3 months had significantly greater odds of RWG in the first year (OR 1·94; 95 % CI 1·25, 3·04) compared to children exclusively breastfed for ≥ 6 months. Associations between breast-feeding duration (total or exclusive) and excess weight at the age of 2 years were not detected. RWG in the first year was found to be the main predictor of excess weight at the age of 2 years (OR 6·98; 95 % CI 4·35, 11·47).
Conclusions:
The potential beneficial effects of breast-feeding on rate of growth in the first year of life suggest that interventions promoting breast-feeding are relevant for obesity prevention early in life.
To describe the duration of breast-feeding between 1990 and 2013 and to estimate the association between breast-feeding duration and sociodemographic, health and pro-breast-feeding policies and programmes in Latin American countries.
Design:
This is a cross-sectional study with data from Demographic and Health Surveys programme conducted in Bolivia, Brazil, Colombia, Peru and the Dominican Republic between 1990 and 2013. The median duration of breast-feeding was estimated by survival analysis. Information on pro-breast-feeding policies and programmes was extracted from the World on Breastfeeding Trends Initiative (WBTi) tool. The association between the duration of breast-feeding and WBTi tool score was analysed by multilevel survival regression.
Setting:
Nationally representative cross-sectional survey from Bolivia, Brazil, Colombia, Peru and Dominican Republic.
Participants:
We included children under 24 months of age, totalling 17 318 children.
Results:
Breast-feeding duration showed a significant increase in all countries, except the Dominican Republic. Mothers with higher schooling level (HR = 1·66; 95 % CI 1·35, 2·04), higher income (HR = 1·58; 95 % CI 1·40, 1·77) and overweight (HR = 1·14; 95 % CI 1·05, 1·23) breastfed for a shorter time. Breast-feeding in the first hour of life (HR = 0·79; 95 % CI 0·74, 0·83) was associated with increase in the duration of breast-feeding. Regarding WBTi, Peru presented the lowest score and the Dominican Republic presented the highest score. WBTi score was inversely related to the duration of breast-feeding for this set of countries (HR = 1·07; 95 % CI 1·02, 1·12).
Conclusions:
Mothers with better socio-economic conditions and overweight breastfed for a shorter time. Breast-feeding in the first hour was associated with longer duration of breast-feeding. In this set of countries, higher scores from WBTi tool did not result in longer duration of breast-feeding.
Breast-feeding is thought to facilitate young children’s acceptance of new foods, including vegetables, but the evidence for this relationship appears inconsistent across studies. Increasing children’s vegetable intake remains challenging; therefore the present study aimed to investigate whether breast-feeding duration predicts vegetable intake in 2–6-year-old children.
Design
Actual vegetable intake was measured in studies across three European countries. General linear model analyses with breast-feeding duration, sex and age of the child and maternal education as variables were used to predict children’s vegetable intake per country. Additionally, the relationships between child eating behaviour characteristics (asked through the Child Eating Behaviour Questionnaire) and vegetable intake were investigated via Pearson correlations.
Setting
Daycare centres, schools and home settings in Denmark, Greece and the Netherlands.
Subjects
Children aged 2–6 years (n 750).
Results
Breast-feeding duration was positively associated with children’s vegetable intake at 2–6 years old in Denmark (P<0·01) and the Netherlands (P<0·05), but not in Greece (P=0·17). Age of the child, maternal education and sex of the child did not predict vegetable intake in our sample. All countries showed an inverse relationship between food neophobia and children’s vegetable intake and a positive relationship between vegetable liking and intake.
Conclusions
The present study found that breast-feeding duration is a predictor of later vegetable intake, but that current child eating behaviour characteristics, such as vegetable liking, food neophobia and enjoyment of food, also influence vegetable intake. Besides encouragement of breast-feeding duration, strategies that support vegetable liking and food enjoyment and decrease food neophobia are needed to support young children’s vegetable intake.
Breast-feeding initiation rates have increased in the USA; however, maintenance of breast-feeding for recommended durations is low. The objective of the present study was to identify factors that may facilitate breast-feeding for longer durations among first-time mothers, including physiological and social experiences and changes in maternal perceptions.
Design
Survival analysis and linear regression methods were used to explore the relationship between experiences and breast-feeding duration, and the possible mediating effect of changes in maternal perceptions.
Setting
Secondary data from the Infant Feeding Practices Study II, conducted in the USA between 2005 and 2007.
Subjects
Data from 762 first-time mothers who ever breast-fed were analysed.
Results
Experiencing trouble with baby’s latch, problems with milk flow/supply and painful breast-feeding were significantly associated with breast-feeding duration (64, 26 and 36 % shorter duration, respectively). Meanwhile, positive changes in perception with respect to breast-feeding self-efficacy, opinion about infant feeding and belief about breast milk were associated with 16–27 % longer duration. Furthermore, changes in perception were observed to partially mediate the impact of physiological experiences on breast-feeding duration.
Conclusions
Perceptions of breast-feeding self-efficacy, beliefs and opinions can change over time and are influenced by breast-feeding experiences. The combined effect of experience and perception plays a key role in influencing breast-feeding duration. Future research should explore interventions to maintain or improve these perceptions while accounting for physiological experiences to support breast-feeding for recommended durations among first-time mothers.
Breast-feeding is associated with positive maternal and infant health and development outcomes. To assist identifying women less likely to meet infant nutritional guidelines, we investigated the role of socio-economic position and parity on initiation of and sustaining breast-feeding for at least 6 months.
Design
Prospective cohort study.
Setting
Australia.
Subjects
Parous women from the Australian Longitudinal Study on Women’s Health (born 1973–78), with self-reported reproductive and breast-feeding history (N 4777).
Results
While 89 % of women (83 % of infants) had ever breast-fed, only 60 % of infants were breast-fed for at least 6 months. Multiparous women were more likely to breast-feed their first child (~90 % v. ~71 % of primiparous women), and women who breast-fed their first child were more likely to breast-feed subsequent children. Women with a low education (adjusted OR (95 % CI): 2·09 (1·67, 2·62)) or a very low-educated parent (1·47 (1·16, 1·88)) had increased odds of not initiating breast-feeding with their first or subsequent children. While fewer women initiated breast-feeding with their youngest child, this was most pronounced among high-educated women. While ~60 % of women breast-fed their first, second and third child for at least 6 months, low-educated women (first child, adjusted OR (95 % CI): 2·19 (1·79, 2·68)) and women with a very low (1·82 (1·49, 2·22)) or low-educated parent (1·69 (1·33, 2·14)) had increased odds of not breast-feeding for at least 6 months.
Conclusions
A greater understanding of barriers to initiating and sustaining breast-feeding, some of which are socio-economic-specific, may assist in reducing inequalities in infant breast-feeding.
To document infant feeding methods in the first six months of life in Xinjiang Uygur Autonomous Region, People's Republic of China, 2003–2004. Some problems with breast-feeding in the area are explained.
Methods
A longitudinal study of infant feeding practices was undertaken. A total of 1219 mothers who delivered babies during 2003 and 2004 were interviewed in five hospitals or institutes, and after discharge were contacted in person or by telephone at approximately monthly intervals to obtain details of infant feeding practices. Multivariate logistic regression analysis was used to explore factors associated with breast-feeding initiation.
Results
‘Any breast-feeding’ rates at discharge and at 0.5, 1.5, 2.5, 3.5, 4.5 and 6 months were 92.2, 91.3, 89.9, 88.8, 87.7, 86.0 and 73.0%, respectively. ‘Exclusive breast-feeding’ rates at discharge and at 0.5, 1.5, 2.5, 3.5, 4.5 and 6 months were 66.2, 47.6, 30.1, 25.8, 22.1, 13.0 and 6.2%, respectively. The main problem of breast-feeding in Xinjiang was the early introduction of formula or water. The average duration of ‘exclusive breast-feeding’ was 1.8 months (95% confidence interval (CI) 1.7–2.0), of ‘full breast-feeding’ 2.8 months (95% CI 2.7–2.9) and of ‘any breast-feeding’ 5.3 months (95% CI 5.2–5.4).
Conclusions
Infant feeding methods in Xinjiang were documented in this study and the main problems with infant feeding in Xinjiang are discussed. Further studies are needed to identify factors associated with ‘exclusive breast-feeding’ and duration.
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