Dataset Information

Perinatal Hospital Practices Are Associated with Breastfeeding through 5 Months Postpartum among Women and Infants from Low-Income Households.

ABSTRACT:

Background

Breastfeeding (BF) provides optimal nutrition during the first 6 mo of life and is associated with reduced infant mortality and several health benefits for children and mothers. However, not all infants in the United States are breastfed, and sociodemographic disparities exist in BF rates. Experiencing more BF-friendly maternity care practices at the hospital is associated with better BF outcomes, but limited research has examined this association among mothers enrolled in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), a population at risk of low BF rates.

Objectives

We assessed the association between BF-related hospital practices (rooming-in, support from hospital staff, and provision of a pro-formula gift pack) and the odds of any or exclusive BF through 5 mo among infants and mothers enrolled in WIC.

Methods

We analyzed data from the WIC Infant and Toddler Feeding Practices Study II, a nationally representative cohort of children and caregivers enrolled in WIC. Exposures included maternal experience of hospital practices reported at 1 mo postpartum, and BF outcomes were surveyed at 1, 3, and 5 mo. ORs and 95% CIs were obtained using survey-weighted logistic regression, adjusting for covariates.

Results

Rooming-in and strong hospital staff support were associated with higher odds of any BF at 1, 3, and 5 mo postpartum. Provision of a pro-formula gift pack was negatively associated with any BF at all time points and with exclusive BF at 1 mo. Each additional BF-friendly hospital practice experienced was associated with 47% to 85% higher odds of any BF over the first 5 mo and 31% to 36% higher odds of exclusive BF over the first 3 mo.

Conclusions

Exposure to BF-friendly hospital practices was associated with BF beyond the hospital stay. Expanding BF-friendly policies at the hospital could increase BF rates in the United States WIC-served population.

SUBMITTER: French CD

PROVIDER: S-EPMC10196577 | biostudies-literature | 2023 Jan

REPOSITORIES: biostudies-literature

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Publications

Perinatal Hospital Practices Are Associated with Breastfeeding through 5 Months Postpartum among Women and Infants from Low-Income Households.

French Caitlin D CD Shafique Mayra A MA Bang Heejung H Matias Susana L SL

The Journal of nutrition 20221220 1

<h4>Background</h4>Breastfeeding (BF) provides optimal nutrition during the first 6 mo of life and is associated with reduced infant mortality and several health benefits for children and mothers. However, not all infants in the United States are breastfed, and sociodemographic disparities exist in BF rates. Experiencing more BF-friendly maternity care practices at the hospital is associated with better BF outcomes, but limited research has examined this association among mothers enrolled in the ...[more]

PMID: 36913468

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Project description:BackgroundBreast milk is the nutrient of choice for preterm infants. The World Health Organization has set a target of ensuring by 2030 that 70 % of infants younger than age 6 months are exclusively breastfed. The breastfeeding status of mothers of preterm infants is far below that target. Preterm infants are a special group, and there are many difficulties in and obstacles to adhering to breastfeeding. It is urgent to understand the current situation of breastfeeding among mothers of preterm infants, the change in their breastfeeding behaviors over time, and factors influencing breastfeeding in this population during different postpartum stages.ObjectiveWe aimed to explore potential breastfeeding behavior trajectories and analyze modifiable influencing factors to provide a reference for health care staff to identify risk groups of breastfeeding attrition at an early stage and develop targeted intervention measures.MethodsWe conducted a prospective, single-center, longitudinal study involving a cohort of mothers of preterm infants from July 2023 to May 2024. We administered the Breastfeeding Behavior Questionnaire, Breastfeeding Intention Questionnaire, Breastfeeding Prediction Scale, Breastfeeding Knowledge Questionnaire, and Edinburgh Postnatal Depression Scale. Data were collected at four timepoints: before discharge (T0) and at 6 weeks (T1), 4 months (T2), and 6 months postpartum (T3). A mixed model of latent variable growth was used to fit the trajectory of maternal breastfeeding behavior, and multiple logistic regression analysis was used to detect factors influencing the trajectory of breastfeeding behavior.ResultsThree types of heterogeneity tracks were found: a "high-level rising" group (36.5 %), "medium-level declining" group (26.0 %), and "low-level declining" group (37.5 %). Household income, spouse's educational background, smoking in the spouse, breastfeeding patterns before discharge (T0), perceived breastfeeding control and breastfeeding intention (T1), perceived breastfeeding control, breastfeeding intention, and breastfeeding knowledge (T2), and perceived breastfeeding control, breastfeeding positive attitude, and breastfeeding negative attitude (T3) were predictors of different profiles.ConclusionBreastfeeding is of great importance to promote the growth and development of preterm infants. However, the breastfeeding situation among mothers of preterm infants 6 months after delivery is not encouraging. The rate of exclusive breastfeeding is low and needs to be improved. Clarifying those variables related to the Theory of Planned Behavior, such as breastfeeding positive and negative attitudes, perceived breastfeeding control, breastfeeding knowledge, and postpartum depression score, can provide a theoretical basis for the early identification and screening of mothers at risk of exclusive breastfeeding attrition. Interventions should be delivered at scale to benefit all new mothers and infants.

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.

Project description:Small and nutritionally at-risk infants under six months, defined as those with wasting, underweight, or other forms of growth failure, are at high-risk of mortality and morbidity. The World Health Organisation 2013 guidelines on severe acute malnutrition highlight the need to effectively manage this vulnerable group, but programmatic challenges are widely reported. This review aims to inform future management strategies for small and nutritionally at-risk infants under six months in low- and middle-income countries (LMICs) by synthesising evidence on existing breastfeeding support packages for all infants under six months. We searched PubMed, CINAHL, Cochrane Library, EMBASE, and Global Health databases from inception to 18 July 2018. Intervention of interest were breastfeeding support packages. Studies reporting breastfeeding practices and/or caregivers'/healthcare staffs' knowledge/skills/practices for infants under six months from LMICs were included. Study quality was assessed using NICE quality appraisal checklist for intervention studies. A narrative data synthesis using the Synthesis Without Meta-analysis (SWiM) reporting guideline was conducted and key features of successful programmes identified. Of 15,256 studies initially identified, 41 were eligible for inclusion. They were geographically diverse, representing 22 LMICs. Interventions were mainly targeted at mother-infant pairs and only 7% (n = 3) studies included at-risk infants. Studies were rated to be of good or adequate quality. Twenty studies focused on hospital-based interventions, another 20 on community-based and one study compared both. Among all interventions, breastfeeding counselling (n = 6) and education (n = 6) support packages showed the most positive effect on breastfeeding practices followed by breastfeeding training (n = 4), promotion (n = 4) and peer support (n = 3). Breastfeeding education support (n = 3) also improved caregivers' knowledge/skills/practices. Identified breastfeeding support packages can serve as "primary prevention" interventions for all infants under six months in LMICs. For at-risk infants, these packages need to be adapted and formally tested in future studies. Future work should also examine impacts of breastfeeding support on anthropometry and morbidity outcomes. The review protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO 2018 CRD42018102795).

Dataset Information

Perinatal Hospital Practices Are Associated with Breastfeeding through 5 Months Postpartum among Women and Infants from Low-Income Households.

Background

Objectives

Methods

Results

Conclusions

Publications

Perinatal Hospital Practices Are Associated with Breastfeeding through 5 Months Postpartum among Women and Infants from Low-Income Households.

Similar Datasets

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