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Gestational, perinatal, and postnatal factors that interfere with practice of exclusive breastfeeding by six months after birth.

ABSTRACT: Despite evidences indicating the superiority of breastfeeding and recent advances in the indicators of breastfeeding in Brazil, exclusive breastfeeding (EBF) during the first six months after birth continues to be an infrequent practice in the country. The objective of the present study was to determine which gestational, perinatal, and postnatal factors of the mother-baby dyad might be associated with the cessation of EBF by six months after birth.Data were collected at the rooming-in facility of the Reference Center of Women's Health of Ribeirão Preto-Mater (CRSM-Mater) during the postpartum period (24 to 72 h after birth) from December 2012 to April 2013 and by telephone contact between the researcher and participating mothers by six months after birth. Questionnaires were applied to collect data, such as the practice of EBF in the last 24 h in the sixth month after birth. The hierarchical theoretical model was proposed and data were analyzed statistically by log-binomial regression models using SAS 9.3.The study involved 283 mother-baby dyads in which the mother evaluated did not present pregnancy-puerperal complications that could impede breastfeeding and confirmed the interest in breastfeeding her child. After the telephone contact in the exact sixth month after the birth of each participating baby, 84.8% of the participating mothers reported that they were no longer exclusively breastfeeding their babies. After statistical analysis, we found that there was a significant association between cessation of EBF and maternal report of previous experience with EBF for one month (0.91, 95% CI 0.81, 0.99) and six months (0.81; 95% CI 0.68, 0.94). These practices were associated with the maintenance of EBF and, even after adjustment for maternal socio-demographic variables, this association was maintained (0.85; 95% CI 0.73, 0.99). Thus, there is a greater chance of practicing and maintaining EBF by six months after birth when mother had previous experience with it.The identification of the risk variables associated with cessation of EBF by six months postpartum, such as previous experience with exclusive breastfeeding, may contribute to the effectiveness of EBF intervention and support measures during the first six months after birth.

SUBMITTER: Moraes de Oliveira M

PROVIDER: S-EPMC5627475 | biostudies-other | 2017

REPOSITORIES: biostudies-other

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Gestational, perinatal, and postnatal factors that interfere with practice of exclusive breastfeeding by six months after birth.

Moraes de Oliveira Mariana M Camelo José Simon JS

International breastfeeding journal 20171003

<h4>Background</h4>Despite evidences indicating the superiority of breastfeeding and recent advances in the indicators of breastfeeding in Brazil, exclusive breastfeeding (EBF) during the first six months after birth continues to be an infrequent practice in the country. The objective of the present study was to determine which gestational, perinatal, and postnatal factors of the mother-baby dyad might be associated with the cessation of EBF by six months after birth.<h4>Methods</h4>Data were co ...[more]

PMID: 29026430

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Project description:Introduction:Practicing exclusive breastfeeding (EBF) in an infant's first six months of life is recommended by the World Health Organization because of its proven effectiveness as a method to support the infant's short- and long-term physical and cognitive development. However, many countries, including Cambodia, face contextually driven challenges in meeting this optimum standard of breastfeeding. The recent declining EBF rate in Cambodia is a concerning indicator of the impact of these challenges. Methods:We used existing data from the 2014 Cambodian Demographic and Health Survey (CDHS) to analyze 717 Cambodian mother-infant pairs. CDHS 2014 used a two-stage stratified cluster sampling approach to select samples. A multivariable logistic regression analysis was used to assess determinants of EBF, taking into account the sampling weight in the analysis. Adjusted odds ratios (AOR) with 95% confidence intervals (CI) were calculated, and significance level was considered at p value < 0.05. Results:Our findings indicate that among mothers with infants under six months, EBF was more likely if they resided rurally (AOR = 2.28; 95% CI 1.23-4.23) and if they delivered at a public hospital (AOR = 2.64; 95% CI 1.28-5.47). On the other hand, mothers of middle wealth index practiced EBF less than mothers of low wealth index (AOR = 0.58; 95% CI 0.34-0.99). And as expected, our analysis confirmed that the older the infants grew, the less likely they were to be exclusively breastfed than those younger than one month old (2-3 months: AOR = 0.49; 95% CI 0.26-0.92; 4-5 months: AOR = 0.25; 95% CI 0.15-0.43). Conclusion:The findings emphasize the need to address these determinants adequately by appropriate interventions to halt the declining trend of EBF practice. We recommend a multifaceted approach to improve EBF rates in Cambodia. Advocacy around EBF at public hospitals should continue, and private hospital staff should receive training to provide EBF counselling and support to mothers.

Project description:IntroductionExclusive breastfeeding (EBF) is the safest and healthiest option of feeding among infants in the first 6 months throughout the world. Thus, the promotion of EBF is essential to prevent complex infant health problems even at the adulthood level. But the majority of previous studies focused on individual- level determinants of EBF by using basic regression models in localized areas. This study aimed to identify the determinants of EBF at the individual and community level which would be helpful to design appropriate strategies for improving the practice of EBF.MethodsIt is a secondary data analysis using the 2016 Ethiopian Demographic and Health Survey (EDHS) data. A total of 1185 infants under 6 months of age were included in the analysis. A Multilevel logistic regression model was employed to investigate factors significantly associated with EBF among under-six infants in Ethiopia. Adjusted odds ratio (AOR) with 95% confidence interval (CI) was used to measure the association of variables whereas Intracluster correlation (ICC), median odds ratio (MOR), and proportional change in variance (PCV) were used to measure random effects (variation).ResultIn multilevel logistic regression; 4-5 months age infant (AOR = 0.04, 95%CI:0.02-0.07), female infants (AOR = 2.51, 95%CI:1.61-3.91), infant comorbidities (AOR = 0.35, 95%CI: 0.21-0.57), richest household wealth index (AOR = 10.34, 95%CI: 3.14-34.03) and antenatal care (AOR = 2.25, 95%CI:1.32-3.82) were individual- level determinants significantly associated with exclusive breastfeeding. Whereas, contextual region (AOR = 0.30, 95%CI: 0.10-0.87), community- level of postnatal visit (AOR = 2.77, 95%CI: 1.26-6.58) and community -level of maternal employment (AOR = 2.8, 95%CI: 1.21-6.47) were community level determinants significantly associated with EBF. The full model showed that46.8% of the variation of exclusive breastfeeding was explained by the combined factors at the individual and community levels. Similarly, it showed that the variation in exclusive breastfeeding across communities remained statistically significant (ICC = 8.77% and variance = 0.32 with P<0.001).Conclusion and recommendationOur study showed that both individual and community level determinants were significantly associated with EBF practice among under 6 infants. Based on our findings, it is recommended to promote and enhance antenatal and postnatal care services utilization of mothers to improve exclusive breastfeeding practice and more emphasis should be given to infants with comorbid conditions and those who were living in the pastoralist regions.

Project description:IntroductionDespite widespread advocacy for exclusive breastfeeding, and the associated benefits of exclusive breastfeeding for both infants and mothers, there is low prevalence in both developed and developing countries. Additionally, although several studies have been conducted on exclusive breastfeeding, very few of such studies have linked birth weight and birth size to exclusive breastfeeding. This study seeks to examine the influence of birth weight and birth size on exclusive breastfeeding.MethodologyThis study adopted a sequential explanatory mixed method approach using both quantitative and qualitative methods. The quantitative approach used cross-sectional data from the 2014 Ghana Demographic and Health Survey (GDHS) and the qualitative data from interviews with exclusive breastfeeding mothers from two health facilities in La Nkwantanang Municipal Assembly in Accra, Ghana. Logistic regression analysis was used to examine whether infants birth weight and mothers perceived birth size are associated with the practice of exclusive breastfeeding while the qualitative data provided further insights into the findings from the quantitative analysis.ResultsMajority (85%) of the infants in the study were of normal birth weight while 52% of the infants were perceived by their mothers to be of small birth size. The prevalence of exclusive breastfeeding was found to be 54.8%. The birth weight of infants and mothers' perceived birth size were found to be significant predictors of exclusive breastfeeding. Infants of normal birth weight (OR = 7.532; 95% CI: 2.171-26.132) and high birth weight (OR = 6.654; 95% CI: 1.477-29.978) were more likely to be exclusively breastfed compared to low-birth-weight infants. Similarly, infants perceived to be of normal birth size were more likely (OR = 1.908; 95% CI: 1.058-3.441) to be exclusively breastfed compared to infants perceived to be of small birth size. The findings from the qualitative analysis show that birth weight rather than birth size influence mothers' decision to practice exclusive breastfeeding.ConclusionThe findings of the study underscore the relevance of infant birth weight and perceived birth size in the practice of exclusive breastfeeding and highlights the need to incorporate both actual measurement of birth weight, and perception of infant's birth size into policies targeted at exclusive breastfeeding. There is the need for deliberate targeted efforts at women who deliver infants of low birth weight and women who perceive their children to be of small birth size to practice exclusive breastfeeding.

Project description:Exclusive breastfeeding (EBF) to six months is one of the World Health Organization's (WHOs) infant and young child feeding (IYCF) core indicators. Single 24 h recall method is currently in use to measure exclusive breastfeeding practice among children of age less than six months. This approach overestimates the prevalence of EBF, especially among small population groups. This justifies the need to look for alternative measurement techniques to have a valid estimate regardless of population characteristics.The study involved 422 infants of age less than six months, living in Gurage zone, Southern Ethiopia. The study was conducted from January to February 2016. Child feeding practices were measured for seven consecutive days using 24 h recall method. Recall since birth, was used to measure breastfeeding practices from birth to the day of data collection. Data on EBF obtained by using single 24 h recall were compared with seven days repeated 24 h recall method. McNemar's test was done to assess if a significant difference existed in rates of EBF between measurement methods.The mean age of infants in months was 3 (SD -1.43). Exclusive breastfeeding prevalence was highest (76.7%; 95% CI 72.6, 80.8) when EBF was estimated using single 24 h recall. The prevalence of EBF based on seven repeated 24 h recall was 53.2% (95% CI: 48.3, 58.0). The estimated prevalence of EBF since birth based on retrospective data (recall since birth) was 50.2% (95% CI 45.4, 55.1). Compared to the EBF estimates obtained from seven repeated 24 h recall, single 24 h recall overestimated EBF magnitude by 23 percentage points (95% CI 19.2, 27.8). As the number of days of 24 h recall increased, a significant decrease in overestimation of EBF was observed.A significant overestimation was observed when single 24 h recall was used to estimate prevalence of EBF compared to seven days of 24 h recall. By increasing the observation days we can significantly decrease the degree of overestimation. Recall since birth presented estimates of EBF that is close to seven repeated 24 h recall. This suggests that a week recall could be an alternative indicator to single 24 h recall.

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Gestational, perinatal, and postnatal factors that interfere with practice of exclusive breastfeeding by six months after birth.

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Gestational, perinatal, and postnatal factors that interfere with practice of exclusive breastfeeding by six months after birth.

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