Impact of attitudes on maternal decisions regarding infant feeding

Losch, Mary E.; Dungy, Claibourne I.; Russell, Daniel W.; Dusdieker, Lois B.

doi:10.1016/s0022-3476(95)70342-x

Cited by 147 publications

(124 citation statements)

References 68 publications

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“…32,33 Our findings are consistent with previous studies that document higher discontinuation rates among lowincome mothers and mothers of black race. 7,8,34 Correspondingly, public health efforts are needed to improve the rate of exclusive breastfeeding among non-Hispanic blacks and socioeconomically disadvantaged groups.…”

Section: Comparison With Other Studiessupporting

confidence: 92%

Opinions and Practices of Clinicians Associated With Continuation of Exclusive Breastfeeding

et al. 2004

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ABSTRACT. Background. The American Academy of Pediatrics recommends exclusive breastfeeding for the first 6 months of life. Recent statistics indicate that initiation and maintenance of exclusive breastfeeding are low in the United States. Unfortunately, little information is available on how clinicians and health care organizations can best promote continuation of exclusive breastfeeding.Objective. To identify clinicians' opinions and management practices that are associated with continuation of exclusive breastfeeding.Methods. We conducted a prospective cohort study of low-risk mother-newborn pairs in a large, multispecialty group practice in which the mother was breastfeeding at 4 weeks. Mothers completed telephone interviews at 4 and 12 weeks postpartum, and their data were linked with their obstetric and pediatric clinicians' responses to a cross-sectional mailed survey conducted during the same time period. Obstetric and pediatric clinicians included medical doctors, nurse practitioners, and nurse midwives. Overall response rates were 63% for mothers and 82% for clinicians (54 obstetric and 67 pediatric clinicians). Bivariate and multivariate analyses were conducted to identify the characteristics of clinicians and mothers that predicted exclusive breastfeeding at 12 weeks.Results. Of the 288 mothers who were breastfeeding at 4 weeks and had a complete 12-week interview, 152 (53%) were exclusively breastfeeding their infants at 12 weeks. Mothers who discontinued exclusive breastfeeding were more likely to have experienced problems with their infant latching on or sucking (odds ratio [OR]: 3.8; 95% confidence interval [CI]: 1.5-9.7) or report that a health care provider recommended formula supplementation (OR: 2.3; 95% CI: 1.1-5.0).Clinicians reported limited time during preventive visits to address breastfeeding problems as a very important barrier to promoting breastfeeding. Obstetric providers were least confident in resolving problems with mothers not producing enough breast milk. Pediatric providers were least confident in resolving problems with breast pain or tenderness or cracked or painful nipples.In the final multivariate model, mothers whose pediatric providers recommended formula supplementation if an infant was not gaining enough weight (OR: 3.2; 95% CI: 1.04, 9.7) or who considered their advice to mothers on breastfeeding duration to be not very important (OR: 2.2; 95% CI: 1.2-3.9) were more likely to have discontinued exclusive breastfeeding by 12 weeks postpartum. Black mothers were significantly more likely to discontinue exclusive breastfeeding by 12 weeks.Conclusions. Clinicians' practices regarding formula supplementation of healthy infants and their opinions about the importance of their breastfeeding advice are associated with the likelihood that mothers will continue exclusive breastfeeding. Policies to enhance clinicians' abilities to address breastfeeding problems within the constraints of busy practices could improve their ability to support exclusive breastfeeding. Pediatrics 2004...

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Section: Comparison With Other Studiessupporting

confidence: 92%

Opinions and Practices of Clinicians Associated With Continuation of Exclusive Breastfeeding

et al. 2004

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“…Muitos estudos procuram definir as variáveis determinantes do êxito ou insucesso da amamentação [10][11][12] , o que poderia facilitar estratégias de promoção. Todavia, é prudente sempre levar em consideração que, como hábito alimentar, a amamentação está intrinsecamente ligada ao desenvolvimento e aos padrões culturais de uma determinada população.…”

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Breastfeeding in Montes Claros, Minas Gerais: a representative sample study

Caldeira

Goulart²

2000

J Pediatr (Rio J)

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ResumoObjetivo: Avaliar a situação do aleitamento materno em Montes Claros, entre crianças menores de dois anos de idade, e determinar variáveis associadas a maior risco de desmame precoce.Métodos: Neste estudo transversal foram realizadas entrevistas, por equipe treinada, com 602 mães selecionadas aleatoriamente na área urbana de Montes Claros, de setembro a novembro de 1996. A análise de sobrevivência foi o método utilizado para o cálculo da prevalência e da duração mediana do aleitamento materno. O teste do qui-quadrado foi empregado para comparação das proporções, admitindo-se um nível de confiança de 5%. A razão das prevalências (RP) foi utilizada para medir a força das associações, com intervalo de confiança de 95%. A análise de regressão logística foi utilizada para identificar os fatores de risco para o desmame precoce.Resultados: A duração mediana do aleitamento materno em geral foi de 8,7 meses; entretanto, a duração mediana do aleitamento materno exclusivo foi de apenas 27 dias. Os fatores de risco para o desmame precoce foram baixo peso ao nascimento (OR=2,65; IC95%=1,10-6,40), dificuldades iniciais para amamentar (OR=1,86; IC95%=1,21-2,85) e falta de incentivo para amamentação nas consultas médicas de puericultura (OR=1,75; IC95%=1,15-2,66).Conclusões: Para o aleitamento materno em geral, existe uma situação melhor do que aquela apresentada por outros estudos nacionais, mas ainda aquém do que recomenda a OMS. Existe uma situação crítica em relação ao padrão de amamentação exclusiva. Os fatores associados ao desmame precoce denotam um precário apoio dos serviços de saúde materno-infantis ao aleitamento materno. J. pediatr. (Rio J.). 2000; 76(1):65-72: aleitamento materno, alimentação, desmame, lactação, leite humano e inquérito nutricional. AbstractObjective: To evaluate the situation of breast-feeding in Montes Claros, among under-two-year-old children, and to determine variables associated to major risk for early weaning.Methods: In this cross-sectional study interviews were carried out by trained personnel with 602 mothers selected randomly in the urban area of Montes Claros, from September to November, 1996. The survival analysis was the method used to calculate the prevalence and the median duration of breast-feeding. The chi-square test was conducted to compare the proportions, and the level of significance was set at 5%. The prevalence ratio (PR) was used to measure the strength of the associations, with a 95% confidence interval. The logistic regression analysis was used to identify the risk factors for early weaning.Results: The median duration of breast-feeding in general was 8.7 months; however the median duration of exclusive breastfeeding was only 27 days. The risk factors for early weaning were low birth weight (OR=2.65; CI95%=1.10-6.40), mothers with difficulties to breast-feed in the first days (OR=1.86; CI95%=1.21-2.85) and lack of posnatal medical incentive to breast-feed (OR=1.75; CI95%=1.15-2.66).Conclusions: For breast-feeding in general there is a better situation than that show...

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“…This figure represents only a small increase in breast-feeding initiation from previous NPS (28) (29) , 71 % in the USA (n 3444) (30) and 71 % in the UK (n 18 125) (31) . To improve breast-feeding rates, it is emphasised that ascertaining the factors important to a mother's decision about how to feed her infant is crucial (32) . Moreover, the acquisition of country-specific knowledge about the type and importance of the determinants for breast-feeding is essential for building effective promotion programmes (33) .…”

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confidence: 99%

The prevalence and determinants of breast-feeding initiation and duration in a sample of women in Ireland

Tarrant¹,

Younger²,

Sheridan-Pereira

et al. 2009

Public Health Nutr.

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Objective: To assess breast-feeding initiation and prevalence from birth to 6 months in a sample of mothers in Dublin, and to determine the factors associated with breast-feeding initiation and 'any' breast-feeding at 6 weeks in a sample of Irish-national mothers. Design: This prospective cross-sectional study involved the recruitment of women during the antenatal period, with subsequent follow-up of mothers who delivered healthy, term singleton infants, at 6 weeks and 6 months postpartum. Setting: Participants were recruited from antenatal clinics in the Coombe Women and Infants University Hospital, Dublin. Subjects: In all, 401 Irish-national and forty-nine non-Irish-national mothers met the criteria for inclusion in the present study. Results: Breast-feeding initiation rates of the Irish-national and non-Irish-nationals were 47 % and 79?6 %, respectively. Factors that were significantly (P 5 0?000) associated with both breast-feeding initiation and 'any' breast-feeding at 6 weeks included mothers who were $35 years, educated to third level, reported positive postnatal encouragement to breast-feed from their partners and had a positive antenatal intention to breast-feed. The maternal negative perception that breastfeeding is an embarrassing way to feed an infant was demonstrated as a major barrier to initiation. Conclusions: Breast-feeding initiation and prevalence rates of the Irish-national population remain low and lag considerably behind national and international targets. Inclusion of the partner in breast-feeding promotional initiatives during the antenatal period may be crucial to increase breast-feeding rates in Ireland. Public health campaigns that focus on increasing the social acceptability of breastfeeding may prove effective in addressing this cultural barrier.

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Impact of attitudes on maternal decisions regarding infant feeding

Cited by 147 publications

References 68 publications

Opinions and Practices of Clinicians Associated With Continuation of Exclusive Breastfeeding

Opinions and Practices of Clinicians Associated With Continuation of Exclusive Breastfeeding

Breastfeeding in Montes Claros, Minas Gerais: a representative sample study

The prevalence and determinants of breast-feeding initiation and duration in a sample of women in Ireland

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