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Zhou G, Yan Q, Yu W, Chen C, Jiang H, Cao M, Chen Y, Han G. Effectiveness of immunoprophylaxis for preterm infants of mothers having chronic hepatitis B virus infection: A retrospective study. J Infect Chemother 2025; 31:102680. [PMID: 40139528 DOI: 10.1016/j.jiac.2025.102680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2024] [Revised: 03/04/2025] [Accepted: 03/07/2025] [Indexed: 03/29/2025]
Abstract
BACKGROUND The effectiveness of immunoprophylaxis for preterm infants delivered by hepatitis B virus(HBV)-infected mothers remains unclear. This study aimed to investigate the effectiveness of immunoprophylaxis in preterm infants. METHODS Infants delivered by HBV-infected mothers between January 1, 2016 and December 31, 2018 were enrolled, Preterm infants received hepatitis B vaccine immediately after birth and at one, two and seven months while full-term infants received vaccine immediately after birth and at one and six months. All infants were followed utill 24 months. Effectiveness of immunoprophylaxis in preterm infants was analyzed by comparing the dynamics of HBV markers and responsible factors were investigated using multivariate regression analysis. RESULTS During the study period (2016-2018), 2238 infants were enrolled, including 175 preterm infants and 2063 full-term infants. The differences in the HBsAb concentration between groups were not statistically significant at 7-12 and 24 months of age (P > 0.05), but the concentration in the preterm group were lower relative to the full-term group. Apgar score at 1 min was a predictor of medium-to-high response of HBsAb at 7-12 month (OR 2.687, P = 0.027). CONCLUSIONS HBsAb concentration in preterm infants delivered by HBV-infected mothers who were vaccinated following the "0-1-2-7″ protocol were similar to those in full-term infants, thereby indicating good outcomes. One-minute Apgar score could be used to predict HBsAb levels in preterm infants at 7-12 months of age after completion of the immunoprophylaxis.
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Affiliation(s)
- Guanlun Zhou
- Department of Obstetrics and Gynecology, The Second Hospital of Nanjing, Affiliated to Nanjing University of Chinese Medicine, Nanjing, 210003, Jiangsu, China
| | - Qiao Yan
- Department of Obstetrics and Gynecology, The Second Hospital of Nanjing, Affiliated to Nanjing University of Chinese Medicine, Nanjing, 210003, Jiangsu, China.
| | - Wenjing Yu
- Department of Obstetrics and Gynecology, The Second Hospital of Nanjing, Affiliated to Nanjing University of Chinese Medicine, Nanjing, 210003, Jiangsu, China.
| | - Chao Chen
- Department of Obstetrics and Gynecology, The Second Hospital of Nanjing, Affiliated to Nanjing University of Chinese Medicine, Nanjing, 210003, Jiangsu, China.
| | - Hongxiu Jiang
- Department of Obstetrics and Gynecology, The Second Hospital of Nanjing, Affiliated to Nanjing University of Chinese Medicine, Nanjing, 210003, Jiangsu, China.
| | - Minkai Cao
- Department of Obstetrics, The Affiliated Wuxi Maternity and Child Health Care Hospital of Nanjing Medical University, Wuxi, 214002, Jiangsu, China.
| | - Yan Chen
- Department of Obstetrics and Gynecology, The Second Hospital of Nanjing, Affiliated to Nanjing University of Chinese Medicine, Nanjing, 210003, Jiangsu, China.
| | - Guorong Han
- Department of Obstetrics and Gynecology, The Second Hospital of Nanjing, Affiliated to Nanjing University of Chinese Medicine, Nanjing, 210003, Jiangsu, China.
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Yi Q, Sun W, Hou L, Hao J, Bai H, Li S, Wu J, Yuan C, Li X, Li S, Song P. Lactation duration and the risk of type 2 diabetes mellitus in parous women: A perspective on socioeconomic status disparity. J Adv Res 2025:S2090-1232(25)00079-7. [PMID: 39923994 DOI: 10.1016/j.jare.2025.02.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2024] [Revised: 12/15/2024] [Accepted: 02/05/2025] [Indexed: 02/11/2025] Open
Abstract
BACKGROUND & AIMS Whether and how socioeconomic status (SES) influences the associations between type 2 diabetes mellitus (T2DM) and lactation remains unknown. We aimed to evaluate the associations between lactation duration and T2DM from a perspective of SES disparity. METHODS A total of 263,859 parous women without diabetes at baseline (2004-2008) in the China Kadoorie Biobank were included. Lactation duration was counted for the first-child, per-child and lifetime. The latent class analysis of education level, household income, occupation, and residence was conducted to derive SES as low, intermediate, and high. T2DM cases were identified through linkage with records in hospitals, disease registry system and health insurance data during follow-up (2008-2015). Multivariable Cox proportional hazards regression models were applied to estimate hazard ratios (HRs) and 95 % confidence intervals for T2DM. Population attributable fraction evaluated the cases tied to insufficient lactation by SES. RESULTS In a median 9.2-year follow-up, 8,204 cases were identified. Women who breastfed their first child for 12-24 and > 24 months respectively, had a reduced risk of diabetes (fully adjusted HR: 0.84 [0.75-0.94] and 0.81 [0.70-0.95]). Similar results were found for per-child (0.84 [0.72-0.98] and 0.71 [0.59, 0.85]), and lifetime lactation for > 36 months (0.66 [0.56, 0.77]). For dose-response associations, every 5-month increase in lactation duration (first-child, per-child, lifetime) was linked to a 7 %, 10 %, and 4 % lower T2DM risk. These associations were significant among low SES women but not for intermediate or high SES women. For low SES women, 36.42 % of diabetes cases were attributable to per-child lactation duration of < 24 months, and 5.76 %, 25.37 %, 47.29 %, 19.04 % of cases would be prevented if women lactating for 0, 0-6, 6-12, and 12-24 months extended their per-child lactation duration to at least 2 years. CONCLUSION Longer lactation duration is associated with a decreased risk of T2DM among women, especially those with low SES. The promotion of extended breastfeeding could potentially prevent a significant proportion of diabetes events.
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Affiliation(s)
- Qian Yi
- Center for Clinical Big Data and Statistics of the Second Affiliated Hospital Zhejiang University School of Medicine, School of Public Health Zhejiang University School of Medicine, China; School of Public Health, Zhejiang University School of Medicine, Hangzhou 310058 China.
| | - Weidi Sun
- School of Public Health, Zhejiang University School of Medicine, Hangzhou 310058 China.
| | - Leying Hou
- School of Public Health, Zhejiang University School of Medicine, Hangzhou 310058 China.
| | - Jiajun Hao
- School of Public Health, Zhejiang University School of Medicine, Hangzhou 310058 China.
| | - He Bai
- School of Public Health, Zhejiang University School of Medicine, Hangzhou 310058 China.
| | - Shuting Li
- School of Public Health, Zhejiang University School of Medicine, Hangzhou 310058 China.
| | - Jing Wu
- School of Public Health, Zhejiang University School of Medicine, Hangzhou 310058 China.
| | - Changzheng Yuan
- School of Public Health, Zhejiang University School of Medicine, Hangzhou 310058 China.
| | - Xue Li
- School of Public Health, Zhejiang University School of Medicine, Hangzhou 310058 China.
| | - Sheyu Li
- Department of Endocrinology and Metabolism and Department of Guideline and Rapid Recommendation, Cochrane China Center, MAGIC China Center, Chinese Evidence-Based Medicine Center, West China Hospital, Sichuan University, Chengdu, China.
| | - Peige Song
- Center for Clinical Big Data and Statistics of the Second Affiliated Hospital Zhejiang University School of Medicine, School of Public Health Zhejiang University School of Medicine, China.
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Zhang R, Ying E, Wu X, Qin H, Guo Y, Guo X, Yu Z, Chen J. A systematic review and meta-analysis of breastfeeding and neurodevelopmental outcomes in preterm infant. Front Public Health 2024; 12:1401250. [PMID: 39639909 PMCID: PMC11617369 DOI: 10.3389/fpubh.2024.1401250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2024] [Accepted: 11/08/2024] [Indexed: 12/07/2024] Open
Abstract
Background Prematurity significantly impacts neonatal health worldwide, necessitating effective interventions to improve outcomes for these vulnerable infants. While breastfeeding has emerged as a cornerstone of preterm care, its precise impact on neurodevelopment remains a subject of ongoing inquiry and debate. This systematic review aims to investigate the existing evidence in this area. Methods On December 17, 2023, online databases including PubMed, The Cochrane Library, Embase, Web of Science, CNKI, VIP, CBM, and Wan Fang Data were searched. Comparisons were classified into several categories: never breastfeeding (Never-BF) versus exclusive breastfeeding, Never-BF versus any breastfeeding (Any-BF), predominant preterm formula (Pre-PTF) versus predominant breastfeeding (Pre-BF), and Pre-PTF versus predominant donor breast milk (Pre-DBM) groups. Randomized controlled trials and observational studies were analyzed separately through meta-analyses. Each study's risk of bias was assessed, and the GRADE system was utilized to evaluate the certainty of the findings. Results Sixteen studies met the inclusion criteria, comprising one RCT and 15 cohort studies. The key findings indicated that infants in the Any-BF groups demonstrated superior long-term cognitive scores compared to those in the Never-BF groups, particularly evident in infants assessed before 18 months in the Pre-BF groups versus Pre-PTF groups. A reduced risk of neurodevelopmental impairment was also observed in preterm infants in the Any-BF groups. Evidence regarding the effect of breastfeeding on motor development was inconclusive, except for potential motor improvement in extremely low birth weight infants in the Any-BF groups. Neither exclusive breastfeeding nor pre-DBM exhibited clear superiority over Pre-PTF in terms of neurodevelopmental outcomes for preterm infants. Caution is warranted due to potential publication bias impacting the assessment of breastfeeding's impact on motor skills. Conclusion Our systematic review supports current recommendations for breastfeeding in preterm infants, emphasizing its positive effects on cognitive abilities and reduced risk of neurodevelopmental disorders. Further studies are needed to clarify if DHM provides neurodevelopmental benefits comparable to maternal milk, as current evidence does not sufficiently address this question. Additionally, future investigations should prioritize refining our understanding of the influence of breastfeeding on motor development in this vulnerable population. Systematic review registration PROSPERO, identifier CRD42023492274, Available at: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023492274.
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Affiliation(s)
- Ruolin Zhang
- Department of Neonatology, Nanshan Maternity & Child Healthcare Hospital, Shenzhen, Guangdong, China
| | - Erya Ying
- Department of Neonatology, Nanshan Maternity & Child Healthcare Hospital, Shenzhen, Guangdong, China
| | - Xiujuan Wu
- Department of Neonatology, Nanshan Maternity & Child Healthcare Hospital, Shenzhen, Guangdong, China
| | - Han Qin
- Department of Neonatology, Nanshan Maternity & Child Healthcare Hospital, Shenzhen, Guangdong, China
| | - Yanping Guo
- Department of Pediatrics, Peking University Shenzhen Hospital, Shenzhen, Guangdong, China
| | - Xin Guo
- Department of Neonatology, Longgang District Maternity & Child Healthcare Hospital of Shenzhen City, Longgang Maternity and Child Institute of Shantou University Medical College, Shenzhen, China
| | - Zhangbin Yu
- Department of Neonatology, Shenzhen People's Hospital, The Second Clinical Medical College of Jinan University, First Affiliated Hospital of Southern University of Science and Technology, Shenzhen, China
| | - Jun Chen
- Department of Neonatology, Nanshan Maternity & Child Healthcare Hospital, Shenzhen, Guangdong, China
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Zhang Z, Li S, Zhai Z, Qiu T, Zhou Y, Zhang H. Temporal Trends in the Prevalence of Child Undernutrition in China From 2000 to 2019, With Projections of Prevalence in 2030: Cross-Sectional Analysis. JMIR Public Health Surveill 2024; 10:e58564. [PMID: 39382950 PMCID: PMC11499720 DOI: 10.2196/58564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2024] [Revised: 07/21/2024] [Accepted: 08/23/2024] [Indexed: 10/10/2024] Open
Abstract
BACKGROUND Although the problem of malnutrition among children in China has greatly improved in recent years, there is a gap compared to developed countries, and there are differences between provinces. Research on long-term comprehensive trends in child growth failure (CGF) in China is needed for further improvement. OBJECTIVE The purpose of this study was to examine trends in stunting, wasting, and underweight among children younger than 5 years in China from 2000 to 2019, and predict CGF till 2030. METHODS We conducted a cross-sectional analysis using data from the local burden of disease (LBD) database. Using Joinpoint Regression Software, we examined trends in CGF among children younger than 5 years in China from 2000 to 2019, and predicted the trends of prevalence in 2030, using the Holt-Winters model with trends but without seasonal components. The assessment was performed with Stata 17 (StataCorp). Data were analyzed from October 17, 2023, to November 22, 2023. RESULTS In 2019, the prevalences of stunting, wasting, and underweight decreased to 12%, 3%, and 4%, respectively (decreases of 36.9%, 25.0%, and 42.9%, respectively, compared with the values in 2000). The prevalence of CGF decreased rapidly from 2000 to 2010, and the downward trend slowed down after 2010. Most provinces had stagnated processes of trends after 2017. The age group with the highest stunting prevalence was children aged 1 to 4 years, and the highest prevalence of wasting and underweight was noted in early neonatal infants. From 2000 to 2019, the prevalence of CGF declined in all age groups of children. The largest relative decrease in stunting and underweight was noted in children aged 1 to 4 years, and the largest decrease in wasting was noted in early neonatal infants. The prevalences of stunting, wasting, and underweight in China are estimated to decrease to 11.4%, 3.2%, and 4.1%, respectively, by 2030. China has nationally met the World Health Organization's Global Nutrition Targets for 2030 for stunting but not for wasting. CONCLUSIONS This study provides data on the prevalence and trends of CGF among children younger than 5 years and reports declines in CGF. There remain areas with slow progress in China. Most units have achieved the goal for stunting prevalence but not wasting prevalence.
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Affiliation(s)
- Zeyu Zhang
- Wuxi School of Medicine, Jiangnan University, Wuxi, China
- Department of Child Health Care, Wuxi Maternity and Child Health Care Hospital, Wuxi, China
| | - Sijia Li
- Wuxi School of Medicine, Jiangnan University, Wuxi, China
- Department of Child Health Care, Wuxi Maternity and Child Health Care Hospital, Wuxi, China
| | - Zidan Zhai
- Wuxi School of Medicine, Jiangnan University, Wuxi, China
- Department of Child Health Care, Wuxi Maternity and Child Health Care Hospital, Wuxi, China
| | - Ting Qiu
- Department of Child Health Care, Wuxi Maternity and Child Health Care Hospital, Wuxi, China
| | - Yu Zhou
- Department of Child Health Care, Wuxi Maternity and Child Health Care Hospital, Wuxi, China
| | - Heng Zhang
- Wuxi School of Medicine, Jiangnan University, Wuxi, China
- Department of Child Health Care, Wuxi Maternity and Child Health Care Hospital, Wuxi, China
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Zhang CY, Zhao W, Pan XP, Huang AQ. Effects of feeding patterns during the first 6 months on weight development of infants ages 0-12 months: a longitudinal study. Sci Rep 2024; 14:17451. [PMID: 39075043 PMCID: PMC11286799 DOI: 10.1038/s41598-024-58164-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 03/26/2024] [Indexed: 07/31/2024] Open
Abstract
The purpose of this study was to investigate the effect of feeding patterns during the first 6 months on weight development of infants ages 0-12 months. Using monitoring data from the Maternal and Child Health Project conducted by the National Center for Women and Children's Health of the Chinese Center for Disease Control and Prevention from September 2015 to June 2019, we categorized feeding patterns during the first 6 months as exclusive breastfeeding, formula feeding, or mixed feeding. We calculated weight-for-age Z scores (WAZ) according to the World Health Organization's (WHO) 2006 Child Growth Standard using WHO Anthro version 3.2.2. A multilevel model was used to analyze the effect of feeding patterns during the first 6 months on the WAZ of infants ages 0-12 months in monitoring regions. Length of follow-up (age of infants) was assigned to level 1, and infants was assigned to level 2. Characteristics of infants, mothers, and families and region of the country were adjusted for in the model. The average weight of infants ages 0-12 months in our study (except the birth weights of boys who were formula fed or mixed fed) was greater than the WHO growth standard. After we adjusted for confounding factors, the multilevel model showed that the WAZ of exclusively breastfed and mixed-fed infants were statistically significantly higher than those of formula-fed infants (coefficients = 0.329 and 0.159, respectively; P < 0.05), and there was a negative interaction between feeding patterns and age (both coefficients = - 0.020; P < 0.05). Infants who were exclusively breastfed were heavier than formula-fed infants from birth until 12 months of age. Mixed-fed infants were heavier than formula-fed infants before 8 months, after which the latter overtook the former. Infants' weight development may be influenced by feeding patterns during the first 6 months. Exclusive breastfeeding during the first 6 months may be beneficial for weight development of infants in infancy.
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Affiliation(s)
- Chun-Ying Zhang
- National Center for Women and Children's Health, Chinese Center for Disease Control and Prevention, Beijing, 100081, China
- Hebei Provincial National Center for Women and Children's Health, Hebei, 050031, China
| | - Wei Zhao
- National Center for Women and Children's Health, Chinese Center for Disease Control and Prevention, Beijing, 100081, China
| | - Xiao-Ping Pan
- National Center for Women and Children's Health, Chinese Center for Disease Control and Prevention, Beijing, 100081, China
| | - Ai-Qun Huang
- National Center for Women and Children's Health, Chinese Center for Disease Control and Prevention, Beijing, 100081, China.
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Chen Y, Guo Y, Wu Y, Medina A, Zhou H, Darmstadt GL. Maternal empowerment, feeding knowledge, and infant nutrition: Evidence from rural China. J Glob Health 2024; 14:04094. [PMID: 38845456 PMCID: PMC11157471 DOI: 10.7189/jogh.14.04094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2024] Open
Abstract
Background Maternal empowerment - the capacity to make decisions within households - is linked to better child feeding and nutritional outcomes, but few studies have considered the mediating role of caregiver knowledge. Further, existing literature centres primarily on the husband-wife dyad while overlooking grandmothers as important childcare decision-makers. Methods We collected primary data through household surveys in 2019 and 2021 from 1190 households with infants zero to six months living in rural western China. We identified the primary and secondary caregivers for each infant and assessed their feeding knowledge and practices, as well as infant nutritional status. We constructed a maternal empowerment index using a seven-item decision-making questionnaire and examined the relationship between maternal empowerment in childcare and household decisions, caregivers' feeding knowledge, and infant feeding practices and nutritional outcomes. Results Mothers had significantly higher levels of feeding knowledge than secondary caregivers (most were grandmothers, 72.7%), with average knowledge scores of 5.4 vs. 4.1, respectively, out of 9. Mothers and secondary caregivers with higher levels of feeding knowledge had significantly higher exclusive breastfeeding rates by 13-15 percentage points (P < 0.01) and 11-13 percentage points (P < 0.01), respectively. The knowledge of secondary caregivers was even more strongly associated with not feeding formula (15 percentage points, P < 0.01). Mothers empowered to make childcare decisions were more likely to exclusively breastfeed (12-13 percentage points, P < 0.01), less likely to formula feed (9-10 percentage points, P < 0.05), and more likely to have children with higher Z-scores for length-for-age (0.32-0.33, P < 0.01) and weight-for-age (0.24-0.25, P < 0.05). Effects remained after controlling for maternal feeding knowledge. Conclusions While mothers' and grandmothers' feeding knowledge was both important for optimal infant feeding, grandmothers' knowledge was particularly critical for practicing exclusive breastfeeding. Given the disparity in feeding knowledge between the two caregivers, our study further shows that mothers empowered in childcare decision-making were more likely to exclusively breastfeed their infants. This implies that some mothers with adequate knowledge may not practice optimal feeding because of lower decision-making power. Overall, our study highlights the role of secondary caregivers (grandmothers) in infant care and suggests that future child nutritional interventions may benefit from involving secondary caregivers (grandmothers). Registration Parent trial registration: ISRCTN16800789.
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Affiliation(s)
- Yunwei Chen
- Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Yian Guo
- Stanford Center on China’s Economy and Institutions, Stanford University, Stanford, California, USA
| | - Yuju Wu
- Department of Health Behavior and Social Medicine, West China School of Public Health and West China Fourth Hospital, Sichuan University, Sichuan, China
| | - Alexis Medina
- Stanford Center on China’s Economy and Institutions, Stanford University, Stanford, California, USA
| | - Huan Zhou
- Department of Health Behavior and Social Medicine, West China School of Public Health and West China Fourth Hospital, Sichuan University, Sichuan, China
| | - Gary L Darmstadt
- Department of Pediatrics, Stanford University School of Medicine, Stanford, California, USA
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Mao S, He J, Huang L, Sun Y, Dai Y, Guo Q, Qiu C, Song X, Lin X, Chen S, Ye L, Xu R. A survey of breastfeeding among women with previous surgery for benign breast disease: a descriptive exploratory study. Int Breastfeed J 2024; 19:41. [PMID: 38840129 PMCID: PMC11151528 DOI: 10.1186/s13006-024-00647-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Accepted: 05/24/2024] [Indexed: 06/07/2024] Open
Abstract
BACKGROUND Surgery is the primary treatment for benign breast disease and causes some disruption to the normal physiology of the breast, even when this disruption is localised, it remains unclear whether it affects women's ability to breastfeed. There are only a few studies describing the experience of breastfeeding in women who have undergone benign breast disease (BBD) surgery. METHODS We retrospectively analysed data from patients aged 20-40 years in Guangdong, China, who underwent breast lumpectomy for BBD in our department between 01 January 2013 and 30 June 2019, with a follow-up date of 01 February 2022. Patients were included who had a history of childbirth between the time of surgery and the follow-up date. By collecting general information about this group of patients and information about breastfeeding after surgery, we described the breastfeeding outcomes of women of a fertile age who had previously undergone surgery for benign breast disease. RESULTS With a median follow-up of 5.9 years, a total of 333 patients met the inclusion criteria. From the breastfeeding data of the first child born postoperatively, the mean duration of 'exclusive breastfeeding' was 5.1 months, and the mean duration of 'any breastfeeding' was 8.8 months. The rate of 'ever breastfeeding' is 91.0%, which is lower than the national average of 93.7%, while the exclusive breastfeeding rate at six months was 40.8%, was higher than the 29.2% national average. The any breastfeeding rate at 12 months was 30.0%, which was well below the 66.5% national average. The common reason for early breastfeeding cessation was insufficient breast milk. A total of 29.0% of patients who had ever breastfed after surgery voluntarily reduced the frequency and duration of breastfeeding on the operated breast because of the surgery. CONCLUSIONS There are some impacts of BBD surgery on breastfeeding and some may be psychological. Institutions should provide more facilities for mothers who have undergone breast surgery to help them breastfeed, such as conducting community education on breastfeeding after breast surgery, training professional postoperative lactation consultants in hospitals, and extending maternity leave. Families should encourage mothers to breastfeed with both breasts instead of only the non-operated breast.
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Affiliation(s)
- Siying Mao
- Breast Department, Guangdong Provincial Hospital of Chinese Medicine, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Jiafa He
- Breast Department, Guangdong Provincial Hospital of Chinese Medicine, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Lezhen Huang
- Breast Department, Guangdong Provincial Hospital of Chinese Medicine, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Yang Sun
- Breast Department, Guangdong Provincial Hospital of Chinese Medicine, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Yan Dai
- Breast Department, Guangdong Provincial Hospital of Chinese Medicine, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Qianqian Guo
- Breast Department, Guangdong Provincial Hospital of Chinese Medicine, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Chang Qiu
- Breast Department, Guangdong Provincial Hospital of Chinese Medicine, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Xue Song
- Breast Department, Guangdong Provincial Hospital of Chinese Medicine, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Xiaojie Lin
- Breast Department, Guangdong Provincial Hospital of Chinese Medicine, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Shengying Chen
- Breast Department, Guangdong Provincial Hospital of Chinese Medicine, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Lingling Ye
- Breast Department, Guangdong Provincial Hospital of Chinese Medicine, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Rui Xu
- Breast Department, Guangdong Provincial Hospital of Chinese Medicine, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China.
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Huang Y, Zhang L, Ainiwan D, Alifu X, Cheng H, Qiu Y, Zhou H, Liu H, Yu Y. Breastfeeding, Gestational Diabetes Mellitus, Size at Birth and Overweight/Obesity in Early Childhood. Nutrients 2024; 16:1351. [PMID: 38732598 PMCID: PMC11085597 DOI: 10.3390/nu16091351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2024] [Revised: 04/24/2024] [Accepted: 04/28/2024] [Indexed: 05/13/2024] Open
Abstract
Background: Breastfeeding appears to reduce the risk of childhood overweight/obesity. However, it remains unclear whether this protective effect persists among high-risk populations. This study aims to investigate the association of breastfeeding with the risk of overweight/obesity in early childhood and whether this association is altered by gestational diabetes mellitus (GDM) or size at birth. Methods: Feeding practices during the first 12 months of age and weight and length at 12-36 months of age were collected. Full breastfeeding includes exclusive and predominant breastfeeding. Children with body mass index (BMI) values greater than 1 standard deviation from the mean of sex- and age-specific BMI were classified as overweight/obese. Multiple generalized estimating equations models were applied to analyze the associations of full breastfeeding duration with overweight/obesity risk. Results: Among all participants (n = 9329), infants with a longer full-breastfeeding duration had a reduced risk of overweight/obesity in early childhood compared with those breastfed for less than one month. Infants exposed to GDM and those born large for gestational age (LGA) had a higher risk of overweight/obesity in early childhood. Among infants of mothers with GDM (n = 1748), infants with full breastfeeding for greater than 6 months (aOR: 0.58; 95% CI: 0.44, 0.78) showed a decreased risk of overweight/obesity in early childhood compared with those breastfed for less than one month. Among LGA infants (n = 1279), infants with full breastfeeding for 3-5 months (aOR: 0.66; 95% CI: 0.57, 0.76) and greater than 6 months (aOR: 0.70; 95% CI: 0.56, 0.88) showed a decreased risk of overweight/obesity in early childhood. Similar results were observed among LGA infants of mothers with GDM. Conclusions: Initiating and prolonging breastfeeding would reduce the risk of overweight/obesity in early childhood, and LGA infants and infants born to mothers with GDM would experience greater benefits.
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Affiliation(s)
- Ye Huang
- Department of Public Health and Department of Anesthesiology, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310009, China; (Y.H.); (L.Z.); (D.A.); (X.A.); (H.C.); (Y.Q.); (H.Z.)
- Department of Epidemiology & Health Statistics, School of Public Health, School of Medicine, Zhejiang University, Hangzhou 310058, China
| | - Libi Zhang
- Department of Public Health and Department of Anesthesiology, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310009, China; (Y.H.); (L.Z.); (D.A.); (X.A.); (H.C.); (Y.Q.); (H.Z.)
- Department of Epidemiology & Health Statistics, School of Public Health, School of Medicine, Zhejiang University, Hangzhou 310058, China
| | - Diliyaer Ainiwan
- Department of Public Health and Department of Anesthesiology, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310009, China; (Y.H.); (L.Z.); (D.A.); (X.A.); (H.C.); (Y.Q.); (H.Z.)
- Department of Epidemiology & Health Statistics, School of Public Health, School of Medicine, Zhejiang University, Hangzhou 310058, China
| | - Xialidan Alifu
- Department of Public Health and Department of Anesthesiology, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310009, China; (Y.H.); (L.Z.); (D.A.); (X.A.); (H.C.); (Y.Q.); (H.Z.)
- Department of Epidemiology & Health Statistics, School of Public Health, School of Medicine, Zhejiang University, Hangzhou 310058, China
| | - Haoyue Cheng
- Department of Public Health and Department of Anesthesiology, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310009, China; (Y.H.); (L.Z.); (D.A.); (X.A.); (H.C.); (Y.Q.); (H.Z.)
- Department of Epidemiology & Health Statistics, School of Public Health, School of Medicine, Zhejiang University, Hangzhou 310058, China
| | - Yiwen Qiu
- Department of Public Health and Department of Anesthesiology, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310009, China; (Y.H.); (L.Z.); (D.A.); (X.A.); (H.C.); (Y.Q.); (H.Z.)
- Department of Epidemiology & Health Statistics, School of Public Health, School of Medicine, Zhejiang University, Hangzhou 310058, China
| | - Haibo Zhou
- Department of Public Health and Department of Anesthesiology, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310009, China; (Y.H.); (L.Z.); (D.A.); (X.A.); (H.C.); (Y.Q.); (H.Z.)
- Department of Epidemiology & Health Statistics, School of Public Health, School of Medicine, Zhejiang University, Hangzhou 310058, China
| | - Hui Liu
- Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou 310016, China;
| | - Yunxian Yu
- Department of Public Health and Department of Anesthesiology, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310009, China; (Y.H.); (L.Z.); (D.A.); (X.A.); (H.C.); (Y.Q.); (H.Z.)
- Department of Epidemiology & Health Statistics, School of Public Health, School of Medicine, Zhejiang University, Hangzhou 310058, China
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Wu JJ, Zhang QN, Liao SS, Li JH, Zhang JD, Huang JZ. Healthcare providers' perceived barriers to providing breastfeeding support in Northwest rural China. Int Breastfeed J 2024; 19:22. [PMID: 38570781 PMCID: PMC10993573 DOI: 10.1186/s13006-024-00630-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2023] [Accepted: 03/20/2024] [Indexed: 04/05/2024] Open
Abstract
BACKGROUND Healthcare providers play important roles in supporting breastfeeding. Although there has been insufficient actual breastfeeding support from healthcare providers in China, little research has been conducted to understand Chinese healthcare providers' perceived barriers to providing breastfeeding support, especially in rural China. This study aims to identify these perceived barriers to providing breastfeeding support in Northwestern rural China. METHODS This study was conducted during the period from March 2018 to December 2018. Forty-one healthcare providers were recruited through purposive sampling in two rural counties in Northwest China that are in close proximity to each other and share similar demographic features. Participants included obstetrician-gynecologists, midwives, nurses, "village doctors", and township and village maternal and child health workers. Qualitative data were collected through one-on-one in-depth semi-structured interviews and focus group discussions. Transcripts were thematically analyzed. RESULTS Analysis of interview data resulted in four themes that the participants perceived as barriers to supporting breastfeeding: (1) lack of medical resources, within which inadequate staffing, and lack of financial incentives were discussed, (2) lack of clear and specific responsibility assignment, within which no one takes the lead, and mutual buck-passing were discussed, (3) healthcare providers' lack of relevant expertise, within which lack of knowledge and skills, and low prestige of village healthcare providers were discussed, (4) difficulties in accessing mothers, within which medical equipment shortages reduce services utilization, mothers' housing situation, mothers' mobility, and cultural barriers were discussed. CONCLUSIONS The study identified HCPs perceived barriers to providing breastfeeding support. Unique to China's Tri-Level Healthcare System, challenges like staffing and financial incentives are hard to swiftly tackle. Recommendations include mHealth enhancement and clarified responsibilities with incentives and tailored training. Further research is crucial to evaluate these strategies in rural Northwestern China and comparable underdeveloped areas nationwide.
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Affiliation(s)
- Jiao-Jiao Wu
- School of Nursing, Lanzhou University, Yanxi Road 28, Lanzhou, Gansu, China
| | - Qing-Ning Zhang
- School of Philosophy and Sociology, Lanzhou University, 222 Tianshuinan Road, Lanzhou, Gansu, China.
| | - Su-Su Liao
- Institute of Basic Medical Science, Chinese Academy of Medical Sciences & Peking Union Medical College, No. 5 Dongdan Santiao, Beijing, China
| | - Jiang-Hong Li
- Institute for Community Research, 2 Hartford Sq. W., Ste. 210, 06106, Hartford, CT, USA
| | - Jian-Duan Zhang
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan, Hubei, China
| | - Jing-Zhi Huang
- Graduate School of Interdisciplinary Information Studies, The University of Tokyo, 7-3-1 Hongo, Bunkyo, Tokyo, Japan
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Mei H, Zhang Y, Chang R, Xu K, Zhang J, Wang F. Mediating role of birth at a baby-friendly hospital in the association between parental socioeconomic status and infant exclusive breastfeeding at six months old. BMC Public Health 2024; 24:78. [PMID: 38172763 PMCID: PMC10762853 DOI: 10.1186/s12889-023-17586-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2023] [Accepted: 12/26/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND Current evidence suggests that the exclusive breastfeeding (EBF) rate at six months postpartum in China falls considerably below the targets recommended by the World Health Organization (WHO). Socioeconomic disparities in EBF have been observed in developing countries, with significant heterogeneity across studies. Despite the implementation of the Baby-Friendly Hospital Initiative (BFHI) in China since the 1990s to promote breastfeeding, there has been a lack of assessment concerning infants from different socioeconomic backgrounds. This study sought to investigate the association between socioeconomic status (SES) and EBF and explore the potential impact of giving birth at a Baby-Friendly Hospital (BFH) on this association. METHODS We analyzed data from 98,469 mother-child dyads selected from the Maternal and Child Health Management Information System. We used log-binomial models to examine the relationships between SES and EBF, SES and giving birth at a BFH, as well as BFH births and EBF. Additionally, we explored a counterfactual mediation approach to assess the mediating role of BFH births in the SES-EBF association. FINDINGS We identified a significant association between SES and EBF (RRMedium vs. Low = 1.47, 95% CI 1.39-1.55; RRHigh vs. Low = 1.40, 95% CI 1.32-1.49). Mothers with higher SES were more likely to give birth at BFHs (RRMedium vs. Low = 1.85, 95% CI 1.81-1.88; RRHigh vs. Low=2.29, 95% CI 2.25-2.33). The significance of the SES-EBF association was attenuated when the type of hospital for childbirth was considered, revealing the significant mediating effect of BFH births in the SES-EBF association. CONCLUSION Socioeconomic disparities are linked to infant EBF rates, with giving birth at a BFH mediating this association, especially for cases with low SES in rural areas.
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Affiliation(s)
- Hong Mei
- Institute of Maternal and Child Health, Tongji Medical College, Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital, Huazhong University of Science and Technology, 100 Hongkong Road, Wuhan, Hubei, China
| | - Yuanyuan Zhang
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, No.13, Hangkong Road, Wuhan, Hubei, China
| | - Ruixia Chang
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, No.13, Hangkong Road, Wuhan, Hubei, China
| | - Ke Xu
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, No.13, Hangkong Road, Wuhan, Hubei, China
| | - Jianduan Zhang
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, No.13, Hangkong Road, Wuhan, Hubei, China.
| | - Fang Wang
- Department of Obstetrics, Tongji Medical College, Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital, Huazhong University of Science and Technology, 100 Hongkong Road, Wuhan, Hubei, China.
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Kamudoni P, Kiige L, Ortenzi F, Beal T, Nordhagen S, Kirogo V, Arimi C, Zvandaziva C, Garg A, Codjia P, Rudert C. Identifying and understanding barriers to optimal complementary feeding in Kenya. MATERNAL & CHILD NUTRITION 2024; 20 Suppl 3:e13617. [PMID: 38180165 PMCID: PMC10782142 DOI: 10.1111/mcn.13617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 12/07/2023] [Accepted: 12/09/2023] [Indexed: 01/06/2024]
Abstract
Optimal complementary feeding between the ages of 6 and 23 months provides children with the required range of nutritious and safe foods while continuing to be breastfed to meet their needs for essential nutrients and develop their full physical and cognitive potential. The rates of exclusive breastfeeding in the first 6 months of life have increased from 32% in 2008 to 60% in 2022 in Kenya. However, the proportion of children between 6 and 23 months receiving a minimum acceptable diet remains low and has declined from 39% in 2008 to 31% in 2023. The Kenyan Ministry of Health, GAIN and UNICEF collaborated to understand the drivers of complementary feeding practices, particularly proximal determinants, which can be directly addressed and acted upon. A secondary analysis of household surveys and food composition data was conducted to outline children's dietary patterns within the different regions of Kenya and the extent to which the affordability of animal-source foods could be improved. Ethnographic data were analyzed to identify socio-cultural barriers to optimal complementary feeding. Furthermore, we outlined the critical steps for developing user-friendly and low-cost complementary feeding recipes. The results of all the analyses are presented in five of the six papers of this Special Issue with this additional paper introducing the Kenyan context and some of the critical findings. The Special Issue has highlighted multidimensional barriers surrounding the use and availability of animal-source foods. Furthermore, it emphasizes the need for a multi-sectoral approach in enacting policies and programmes that address these barriers.
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Affiliation(s)
| | | | | | - Ty Beal
- Global Alliance for Improved Nutrition (GAIN)WashingtonDCUSA
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Wang XM, Wang QY, Huang J. Anemia status of infants and young children aged six to thirty-six months in Ma'anshan City: A retrospective study. World J Clin Cases 2023; 11:6744-6753. [PMID: 37901006 PMCID: PMC10600847 DOI: 10.12998/wjcc.v11.i28.6744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 08/31/2023] [Accepted: 09/06/2023] [Indexed: 09/25/2023] Open
Abstract
BACKGROUND Anemia in infants and young children can have long-term effects on cognitive and physical development. In Ma'anshan City, China, there has been growing concern about the prevalence of anemia among children aged 6 to 36 mo. Understanding the factors influencing this condition is crucial for targeted interventions and improving overall child health in the region. AIM To analyze the anemia status and influencing factors of infants and young children aged 6 to 36 mo in Ma'anshan City, China. Providing scientific evidence for reducing the incidence of anemia and improving the health level of children in this age group. METHODS The study encompassed 37698 infants and young children, aged from 6 to 36 mo, who underwent health examinations at the Ma'anshan Maternal and Child Health Hospital from January 2018 to October 2022 were included in the study. Basic information, physical examination, and hemoglobin detection data were collected. Descriptive analysis was used to analyze the prevalence of anemia in children in the region, and univariate analysis was used to analyze the influencing factors of anemia. RESULTS The mean hemoglobin level of infants and young children aged 9 to 36 mo increased with age, and the anemia detection rate decreased with age. The anemia detection rate in rural infants aged 6, 9, and 12 mo was higher than that in urban infants. Although the anemia detection rate was higher in 6-mo-old boys than girls, it was higher in 24-mo-old girls than boys. There were statistically significant differences in the anemia detection rates among 9-mo-old and 12-mo-old infants with different nutritional statuses (emaciation, overweight, obese, and normal). Moreover, there were no statistically significant differences in anemia detection rates among infants and young children with different nutritional statuses at other ages. Besides, the anemia detection rates in obese infants aged 9 and 12 mo were higher than those in normal and overweight infants, with statistically significant differences. Finally, there were no statistically significant differences in the anemia detection rates between emaciation infants and those with other nutritional statuses. CONCLUSION The anemia situation among infants and young children aged 6 to 36 mo in Ma'anshan City, China, is relatively prominent and influenced by various factors. Our result shown that attention should be paid to the anemic infant and young child population, with strengthened education and targeted prevention and dietary guidance to help them establish good living habits, improve nutritional status, and reduce the occurrence of anemia to improve children's health levels.
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Affiliation(s)
- Xue-Mei Wang
- Department of Pediatric, Ma’anshan Maternal and Child Health Center, Ma’anshan 243011, Anhui Province, China
| | - Qiong-Yao Wang
- Department of Pediatric, Ma’anshan Maternal and Child Health Center, Ma’anshan 243011, Anhui Province, China
| | - Jie Huang
- Department of Hematology and Oncology, Children's Hospital of Nanjing Medical University, Nanjing 210000, Jiangsu Province, China
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Chen Y, Zhao Y, Wang W, Wang F, Jiang H, Wang L. Factors associated with exclusive breastfeeding during postpartum in Lanzhou city, China: a cross-sectional study. Front Public Health 2023; 11:1089764. [PMID: 37711249 PMCID: PMC10498539 DOI: 10.3389/fpubh.2023.1089764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Accepted: 08/15/2023] [Indexed: 09/16/2023] Open
Abstract
Aim Breastfeeding generates short-term and long-term benefits for both mother and child. Exclusive breastfeeding (EBF) is promoted in China for years, but its practice still lags far behind the international average, even among low- and middle- income countries. This study aimed to investigate factors associated with EBF during postpartum. Methods This study was conducted in a tertiary referral hospital in Gansu Province, Northwest China from October 2019 to April 2020. 3,738 postnatal women were finally included and each of them completed an elaborately designed questionnaire. Infant feeding patterns (EBF or not) and reasons for NEBF (non-exclusive breastfeeding) were collected. The feeding knowledge score was based on 17 questions in relation to breastfeeding. The total score ranges from 0 to 17. Higher score means better understanding about breastfeeding knowledge. Multivariate logistic regression models were used to determine associated factors of EBF during postpartum. A subgroup analysis was conducted to investigate the association between feeding knowledge score and exclusive breastfeeding. Results Six weeks after childbirth, 1891 mothers (50.6%) maintained EBF. Among the NEBF mothers, 57.01% (n = 1,053) of them stopped exclusive breastfeeding due to self-perceived lack of breast milk production. Factors associated with NEBF were higher maternal age, ethnic minorities and cesarean section. Protective factors of EBF included multipara, positive feeding attitude and high breastfeeding knowledge score. In subgroup analysis, we found the breastfeeding knowledge score had a significant impact on the mothers of Han nationality, underwent cesarean or natural delivery, both primiparous and multiparous, and those with positive attitude towards breastfeeding (p < 0.05). Conclusion We need a comprehensive and individualized framework of strategies to support children, mothers and their families. During puerperium, improving maternal knowledge of breastfeeding is beneficial to EBF practice. However, for ethnic minorities and those with less active breastfeeding attitudes, breastfeeding knowledge is of limited use, more researches are needed to explore the uncovered reasons, so that more personalized interventions could be developed for them.
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Affiliation(s)
- Yuelu Chen
- Department of Reproductive Health and Infertility, First Affiliated Hospital of Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory of Maternal and Fetal Medicine, Chongqing Medical University, Chongqing, China
| | - Yong Zhao
- College of Public Health and Management, Chongqing Medical University, Chongqing, China
| | - Wenling Wang
- Perinatology Center, Gansu Provincial Maternity and Child-Care Hospital, Lanzhou, Gansu, China
| | - Fengdi Wang
- Department of Reproductive Health and Infertility, First Affiliated Hospital of Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory of Maternal and Fetal Medicine, Chongqing Medical University, Chongqing, China
| | - Huimin Jiang
- Department of Reproductive Health and Infertility, First Affiliated Hospital of Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory of Maternal and Fetal Medicine, Chongqing Medical University, Chongqing, China
| | - Lianlian Wang
- Department of Reproductive Health and Infertility, First Affiliated Hospital of Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory of Maternal and Fetal Medicine, Chongqing Medical University, Chongqing, China
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Li Z, Jia Y, Parshley I, Zhang Y, Wang J, Long Q. Current prevalence, changes, and determinants of breastfeeding practice in China: data from cross-sectional national household health services surveys in 2013 and 2018. Int Breastfeed J 2023; 18:40. [PMID: 37568207 PMCID: PMC10416475 DOI: 10.1186/s13006-023-00572-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 07/10/2023] [Indexed: 08/13/2023] Open
Abstract
BACKGROUND The World Health Organization and the government of China have made many efforts to improve breastfeeding practices. The evidence of breastfeeding practices over the past decade in China is limited. The current study aimed to describe the current prevalence, variation trends, and determinants of breastfeeding practices in China using data from the National Household Health Service Surveys (NHHSS) in 2013 and 2018. METHODS Women who had at least one live birth in the five years from the 2013 NHHSS numbered 10,544, and 12,766 women from the 2018 NHHSS were included in the current study. The rates of breastfeeding, early initiation of breastfeeding within the first hour after birth, exclusive breastfeeding for at least six months since birth, and continued breastfeeding accompanied by adequate complementary feeding for over two years were measured. Logistic regressions were performed to study the associations between breastfeeding practices and maternal-based, healthcare-based, and infant-based characteristics. RESULTS In the 2018 survey, the rates of practiced any breastfeeding, early initiation of breastfeeding within the first hour after birth, exclusive breastfeeding for at least six months, and continued breastfeeding for over two years were 91.50%, 28.16%, 47.90%, and 4.78%, respectively, showing significant improvements compared to the 2013 survey period. Women who received high education, were from a household with high incomes, had more than one child, and had more antenatal and postnatal visits, were more likely to practice breastfeeding and initiate it within the first hour, but they were less likely to breastfeed the infants for two years. Births by caesarean section and low birthweight were associated with worse breastfeeding practices. CONCLUSIONS The rates of practicing breastfeeding and exclusive breastfeeding for six months or more in China improved over the past decades, suggesting improved awareness and knowledge of breastfeeding among women. However, individual and social factors may impact practices of early initiation and continued breastfeeding. Strengthening breastfeeding support from family, community, and health professionals (e.g., family member engagement, friendly work environment, and professional consultation, etc.) during the postpartum and infant period may improve women's confidence in breastfeeding practices.
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Affiliation(s)
- Zeyu Li
- Global Health Research Center, Duke Kunshan University, Jiangsu, China
| | - Yufei Jia
- Global Health Research Center, Duke Kunshan University, Jiangsu, China
| | - Iris Parshley
- Global Health Research Center, Duke Kunshan University, Jiangsu, China
| | - Yaoguang Zhang
- Centre for Health Statistics and Information, National Health Commission, 38 Beilishi Road, Xicheng, Beijing, 100810, NO, China.
| | - Jia Wang
- Yuzhong District Center for Diseases Prevention and Control, 254 Heping Road, Yuzhong District, Chongqing, 400010, China.
| | - Qian Long
- Global Health Research Center, Duke Kunshan University, Jiangsu, China
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Feng J, Xu L, Chen Y, Lin R, Li H, He H. Trends in incidence and mortality for ovarian cancer in China from 1990 to 2019 and its forecasted levels in 30 years. J Ovarian Res 2023; 16:139. [PMID: 37452315 PMCID: PMC10347789 DOI: 10.1186/s13048-023-01233-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Accepted: 07/07/2023] [Indexed: 07/18/2023] Open
Abstract
BACKGROUND The specific long-term trend in ovarian cancer (OC) rates in China has been rarely investigated. We aimed to estimate the temporal trends in incidence and mortality rates from 1990 to 2019 in OC and predict the next 30-year levels. Data on the incidence, mortality rates, and the number of new cases and deaths cases due to OC in the China cohort from 1990 to 2019 were retrieved from the Global Burden of Disease Study 2019. Temporal trends in incidence and mortality rates were evaluated by joinpoint regression models. The incidence and mortality rates and the estimated number of cases from 2020 to 2049 were predicted using the Bayesian age-period-cohort model. RESULTS Consecutive increasing trends in age-standardized incidence (average annual percent change [AAPC] = 2.03; 95% confidence interval [CI], 1.90-2.16; p < 0.001) and mortality (AAPC = 1.58; 95% CI, 1.38-1.78; p < 0.001) rates in OC were observed from 1990-2019 in China. Theoretically, both the estimated age-standardized (per 100,000 women) incidence (from 4.77 in 2019 to 8.95 in 2049) and mortality (from 2.88 in 2019 to 4.03 in 2049) rates will continue to increase substantially in the coming 30 years. And the estimated number of new cases of, and deaths from OC will increase by more than 3 times between 2019 and 2049. CONCLUSIONS The disease burden of OC in incidence and mortality has been increasing in China over the past 30 years and will be predicted to increase continuously in the coming three decades.
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Affiliation(s)
- Jianyang Feng
- Department of Obstetrics and Gynecology, Guangdong Provincial Key Laboratory of Major Obstetric Disease, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510000, China
| | - Lijiang Xu
- Department of Obstetrics and Gynecology, The First People's Hospital of Foshan, Foshan, 528000, China
| | - Yangping Chen
- Department of Obstetrics and Gynecology, The First People's Hospital of Foshan, Foshan, 528000, China
| | - Rongjin Lin
- Department of Obstetrics and Gynecology, Guangdong Provincial Key Laboratory of Major Obstetric Disease, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510000, China
| | - Haoxian Li
- Department of Obstetrics and Gynecology, Guangdong Provincial Key Laboratory of Major Obstetric Disease, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510000, China
| | - Hong He
- Department of Obstetrics and Gynecology, Guangdong Provincial Key Laboratory of Major Obstetric Disease, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510000, China.
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Kassie GA, Gebrekidan AY, Enaro EY, Asgedom YS. Minimum acceptable dietary intake among children aged 6-23 months in Ethiopia: A systematic review and meta-analysis. PLoS One 2023; 18:e0287247. [PMID: 37384754 PMCID: PMC10310018 DOI: 10.1371/journal.pone.0287247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2022] [Accepted: 06/01/2023] [Indexed: 07/01/2023] Open
Abstract
BACKGROUND In the absence of minimum acceptable diet, children aged 6-23 months are vulnerable to malnutrition. Not feeding at least the minimum acceptable diet is a major global problem, particularly in developing countries. Even though many studies have been conducted in Ethiopia there are inconsistencies. Therefore, this review aimed to estimate the pooled prevalence of a minimum acceptable diet in Ethiopia. METHODS Published articles from various electronic databases, such as PubMed/MEDLINE, EMBASE, Google Scholar, and Science Direct were systematically searched. All cross-sectional studies conducted on the minimum acceptable diet of children aged 6-24 months and published up to October 30/2021 were included in this review. Data were extracted using an Excel spreadsheet and analyzed using STATA version 14.1. The random-effects model was used to estimate the pooled prevalence, and a subgroup analysis was performed to identify the possible source of heterogeneity. Begg's and Egger's tests were used to identify possible publication bias. RESULTS Nine cross-sectional studies involving 4,223 participants were included. Significant heterogeneity was observed across the studies (I2 = 99.4%). The pooled prevalence of minimum acceptable diet in Ethiopia was found to be 25.69% (95% CI: 11.96, 39.41). CONCLUSION This review revealed that the minimum acceptable dietary intake among children aged 6-23 months in Ethiopia was relatively low; only 1 in 4 of children met the minimum acceptable diet. This indicates that the government should promote child feeding practices according to guidelines to increase the proportion of children with a minimum acceptable diet.
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Affiliation(s)
- Gizachew Ambaw Kassie
- School of Public Health, College of Health Science and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| | - Amanuel Yosef Gebrekidan
- School of Public Health, College of Health Science and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| | - Eskinder Yilma Enaro
- School of Public Health, College of Health Science and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| | - Yordanos Sisay Asgedom
- School of Public Health, College of Health Science and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia
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Wu JL, Pang SQ, Jiang XM, Zheng QX, Lin Y. Which mothers' breastfeeding behaviours within six weeks postpartum do health workers need to notice? Developing an indicator system based on the Delphi method and analytic hierarchy process. Midwifery 2023; 119:103603. [PMID: 36724574 DOI: 10.1016/j.midw.2023.103603] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 06/04/2022] [Accepted: 01/22/2023] [Indexed: 01/25/2023]
Abstract
OBJECTIVE The six weeks postpartum is the high-incidence period of stopping breastfeeding. The clarity of the internal mechanism of behaviour was an effective way to promote breastfeeding. The aim was to reach a consensus on indicators what should be used and prioritised in evaluating mothers' breastfeeding behaviour within six weeks postpartum in order to provide a theoretical reference for health workers to take targeted strategies toward promoting breastfeeding practices. DESIGN Two rounds of Delphi method and analytic hierarchy process was conducted in this study. The two-rounds Delphi was performed to select essential indicators and collect revised suggestion. The analytic hierarchy process was adopted for pairwise comparison to rank the significance of primary and secondary indicators. SETTING AND PARTICIPANTS The panel included twenty experts with rich breastfeeding information and different general characteristics from China. FINDINGS Consensus was achieved to include three primary indicators, seven secondary indicators, and forty-five tertiary indicators in the final indicators system of the mothers' breastfeeding behaviour within six weeks postpartum. The weight sequence of primary indicators was self-regulation behaviour (0.401), at-the-breast feeding behaviour (0.383), and resource utilisation behaviour (0.216). The rank of the secondary indicators was breastfeeding operation skills (0.267), self-decision behaviour (0.144), self-control behaviour (0.130), self-coping behaviour (0.127), breastfeeding self-perception (0.116), resource acquisition behaviour (0.115), and resource coordination behaviour (0.101). KEY CONCLUSION The study builds a new and reliable indicators system that intuitively reflects the constituent elements of the mothers' breastfeeding behaviour within six weeks postpartum and provides priorities in primary indicators and secondary indicators. IMPLICATIONS FOR PRACTICES The study helps form a clear and scientific cognition on mothers' breastfeeding behaviour within six weeks postpartum and provides a new perspective and intuitive theoretical reference for health workers to take targeted measures to promote breastfeeding practices and achieve substantial public health gains.
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Affiliation(s)
- Jing-Ling Wu
- School of Nursing, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian, China
| | - Shu-Qin Pang
- School of Nursing, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian, China
| | - Xiu-Min Jiang
- Department of Nursing, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China.
| | - Qing-Xiang Zheng
- Department of Nursing, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China
| | - Yan Lin
- Department of Obstetrics, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China
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Wu JL, Jiang XM, Zheng QX, Chen XQ, Liu GH. Mothers' breastfeeding six weeks postpartum and factors influencing exclusive breastfeeding during the first six months. Health Care Women Int 2023; 44:262-275. [PMID: 34346293 DOI: 10.1080/07399332.2021.1947287] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
We aimed to assess the feeding pattern and influencing factors within six weeks postpartum on exclusive breastfeeding duration among Chinese mothers. This study was conducted using 2:1 matched case-control study. Cases and controls were matched for maternal age, parity and mode of birth. A total of 210 women were included. Approximately 67.9% of women stopped exclusive breastfeeding within the first six weeks postpartum. Maternal non-exclusive breastfeeding intention, lower maternal educational level, mother-infant skin to skin contact over one hour, unsatisfied breastfeeding self-evaluation and maternal unhealthy condition within the first six weeks were risk factors for ceasing exclusive breastfeeding early.
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Affiliation(s)
- Jing-Ling Wu
- School of Nursing, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Xiu-Min Jiang
- Department of Nursing, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Qing-Xiang Zheng
- Department of Nursing, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Xiao-Qian Chen
- Department of Nursing, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Gui-Hua Liu
- Department of Child Health, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, China
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Chen Y, Wu Y, Dill SE, Guo Y, Westgard CM, Medina A, Weber AM, Darmstadt GL, Zhou H, Rozelle S, Sylvia S. Effect of the mHealth-supported Healthy Future programme delivered by community health workers on maternal and child health in rural China: study protocol for a cluster randomised controlled trial. BMJ Open 2023; 13:e065403. [PMID: 36669837 PMCID: PMC9872510 DOI: 10.1136/bmjopen-2022-065403] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Accepted: 01/04/2023] [Indexed: 01/22/2023] Open
Abstract
INTRODUCTION Millions of young rural children in China still suffer from poor health and malnutrition, partly due to a lack of knowledge about optimal perinatal and child care among rural mothers and caregivers. Meanwhile, there is an urgent need to improve maternal mental health in rural communities. Comprehensive home visiting programmes delivered by community health workers (CHWs) can bridge the caregiver knowledge gap and improve child health and maternal well-being in low-resource settings, but the effectiveness of this approach is unknown in rural China. Additionally, grandmothers play important roles in child care and family decision-making in rural China, suggesting the importance of engaging multiple caregivers in interventions. The Healthy Future programme seeks to improve child health and maternal well-being by developing a staged-based curriculum that CHWs deliver to mothers and caregivers of young children through home visits with the assistance of a tablet-based mHealth system. This protocol describes the design and evaluation plan for this programme. METHODS AND ANALYSIS We designed a cluster-randomised controlled trial among 119 rural townships in four nationally designated poverty counties in Southwestern China. We will compare the outcomes between three arms: one standard arm with only primary caregivers participating in the intervention, one encouragement arm engaging primary and secondary caregivers and one control arm with no intervention. Families with pregnant women or infants under 6 months of age are invited to enrol in the 12-month study. Primary outcomes include children's haemoglobin levels, exclusive breastfeeding rates and dietary diversity in complementary feeding. Secondary outcomes include a combination of health, behavioural and intermediate outcomes. ETHICS AND DISSEMINATION Ethical approval has been provided by Stanford University, Sichuan University and the University of Nevada, Reno. Trial findings will be disseminated through national and international peer-reviewed publications and conferences. TRIAL REGISTRATION NUMBER ISRCTN16800789.
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Affiliation(s)
- Yunwei Chen
- Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Yuju Wu
- West China School of Public Health, Sichuan University, Chengdu, China
| | - Sarah-Eve Dill
- Stanford Center on China's Economy and Institutions, Stanford University, Stanford, CA, USA
| | - Yian Guo
- Stanford Center on China's Economy and Institutions, Stanford University, Stanford, CA, USA
| | - Christopher Michael Westgard
- Department of Maternal and Child Health, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Alexis Medina
- Stanford Center on China's Economy and Institutions, Stanford University, Stanford, CA, USA
| | - Ann M Weber
- Department of Biostatistics, Epidemiology and Environmental Health, School of Public Health, University of Nevada, Reno, Reno, NV, USA
| | - Gary L Darmstadt
- Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA
| | - Huan Zhou
- West China School of Public Health, Sichuan University, Chengdu, China
| | - Scott Rozelle
- Stanford Center on China's Economy and Institutions, Stanford University, Stanford, CA, USA
| | - Sean Sylvia
- Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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20
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Li F, Huang C, Lin Q, Xi Y, Xiang C, Yong C, Deng J. Maternal Characteristics, Intention, Self-Efficacy, Perceived Social Support, and Exclusive Breastfeeding Practice: Structural Equation Modeling Approaches. Healthcare (Basel) 2022; 11:healthcare11010087. [PMID: 36611547 PMCID: PMC9819423 DOI: 10.3390/healthcare11010087] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 12/18/2022] [Accepted: 12/24/2022] [Indexed: 12/29/2022] Open
Abstract
Breast milk is a perfect food for infants; however, the rate of exclusive breastfeeding is low. The relationship between exclusive breastfeeding practices and influencing factors is complex and remains unclear. This cross-sectional study was conducted in Changsha County, China, and 414 mothers were enrolled. An online questionnaire was used to collect data on general information, obstetrics and gynecology characteristics, the initial breastfeeding intention, breastfeeding practice, frequency of attending conventional breastfeeding programs before delivery, the status of breastfeeding self-efficacy, and the status of perceived social support. Structural equation modeling (SEM) was used to estimate the association between exclusive breastfeeding and potential risk factors of failing to practice exclusive breastfeeding for 6 months. The rate of exclusive breastfeeding for 6 months was 46.1%. The median and interquartile range of the scores for breastfeeding self-efficacy and perceived social support were 51.0 (18.0) and 68.0 (20.0), respectively. Factors that were statistically significant in the univariate analysis were included in the SEM and model fitness was acceptable based on the results. Exclusive breastfeeding for 6 months was directly associated with intention and self-efficacy, while it was indirectly associated with perceived social support and frequency of attending a breastfeeding program. The findings support the recommendation that comprehensive breastfeeding promotion strategies should be implemented to call on the intention and self-efficacy of breastfeeding mothers through various measures, such as education or providing medical and health services.
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Affiliation(s)
- Fang Li
- Department of Pulmonary and Critical Care Medicine, The Second Xiangya Hospital, Central South University, Changsha 410011, China;
- Hunan Centre for Evidence-Based Medicine, Changsha 410011, China
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha 410078, China
| | - Cailian Huang
- Maternal and Children Health Hospital of Changsha County, Changsha 410100, China;
- Department of Nutrition Science and Food Hygiene, Xiangya School of Public Health, Central South University, Changsha 410078, China; (Q.L.); (Y.X.); (C.X.); (C.Y.)
| | - Qian Lin
- Department of Nutrition Science and Food Hygiene, Xiangya School of Public Health, Central South University, Changsha 410078, China; (Q.L.); (Y.X.); (C.X.); (C.Y.)
| | - Yue Xi
- Department of Nutrition Science and Food Hygiene, Xiangya School of Public Health, Central South University, Changsha 410078, China; (Q.L.); (Y.X.); (C.X.); (C.Y.)
| | - Caihong Xiang
- Department of Nutrition Science and Food Hygiene, Xiangya School of Public Health, Central South University, Changsha 410078, China; (Q.L.); (Y.X.); (C.X.); (C.Y.)
| | - Cuiting Yong
- Department of Nutrition Science and Food Hygiene, Xiangya School of Public Health, Central South University, Changsha 410078, China; (Q.L.); (Y.X.); (C.X.); (C.Y.)
| | - Jing Deng
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha 410078, China
- Hunan Provincial Key Laboratory of Clinical Epidemiology, Changsha 410078, China
- Correspondence:
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21
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Li W, Yuan J, Wang L, Qiao Y, Liu E, Wang S, Leng J. The association between breastfeeding and childhood obesity/underweight: a population-based birth cohort study with repeated measured data. Int Breastfeed J 2022; 17:82. [PMID: 36457121 PMCID: PMC9714094 DOI: 10.1186/s13006-022-00522-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Accepted: 11/14/2022] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND The impact of breastfeeding on childhood obesity has long been under debate, with most research showing significant association, and others showing weak or no association between breastfeeding and childhood obesity. What's more, almost all of the previous studies focused on the association between breastfeeding and childhood obesity, and no studies have assessed the association between breastfeeding and childhood underweight. This study aimed to examine the association between breastfeeding and childhood obesity as well as childhood underweight from 1 to 6 years old. METHODS A retrospective population-based cohort study of 59,564 children born between May 2009 and April 2013 in China was conducted using the healthcare records data from the Tianjin Maternal and Child Healthcare System. Information on infant breastfeeding (exclusive breastfeeding, mixed feeding, and exclusive formula feeding) within 6 months old and childhood growth (6 times of repeated measured weight and height from 1 to 6 years old) was collected. Multinomial logistic regression was used to test the potential associations between infant feeding modalities and childhood growth (underweight, normal weight and obesity). RESULTS Compared with exclusive formula feeding, breastfeeding was inversely associatied with childhood obesity from 2 to 6 years old, and there was a trend from mixed feeding to exclusive breastfeeding (Ptrend < 0.05). The largest association with obesity was displayed at 3 years old, with the multivariable adjusted odds ratios (ORs) for exclusive formula feeding, mixed feeding and exclusive breastfeeding of 1.00, 0.62 (95% CI 0.49, 0.80) and 0.57 (95% CI 0.44, 0.74) (Ptrend = 0.001), respectively. Compared with exclusive breastfeeding, exclusive formula feeding may increase the risk of childhood underweight at 3 and 5 years old. CONCLUSIONS Breastfeeding was inversely associated with the risk of childhood obesity from 2 to 6 years old, and there was a trend from mixed feeding to exclusive breastfeeding. Infant exclusive formula feeding might be a risk factor for childhood underweight at preschool time.
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Affiliation(s)
- Weiqin Li
- Tianjin Women’s and Children’s Health Center, Tianjin, 300070 China
| | - Jiarong Yuan
- Tianjin Women’s and Children’s Health Center, Tianjin, 300070 China
| | - Leishen Wang
- Tianjin Women’s and Children’s Health Center, Tianjin, 300070 China
| | - Yijuan Qiao
- Tianjin Women’s and Children’s Health Center, Tianjin, 300070 China
| | - Enqing Liu
- Tianjin Women’s and Children’s Health Center, Tianjin, 300070 China
| | - Shuo Wang
- Tianjin Women’s and Children’s Health Center, Tianjin, 300070 China
| | - Junhong Leng
- Tianjin Women’s and Children’s Health Center, Tianjin, 300070 China
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22
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Zou H, Sun M, Liu Y, Xi Y, Xiang C, Yong C, Liang J, Huo J, Lin Q, Deng J. Relationship between Dietary Inflammatory Index and Postpartum Depression in Exclusively Breastfeeding Women. Nutrients 2022; 14:nu14235006. [PMID: 36501036 PMCID: PMC9738724 DOI: 10.3390/nu14235006] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Revised: 11/19/2022] [Accepted: 11/22/2022] [Indexed: 11/27/2022] Open
Abstract
(1) Background: Research has shown that chronic inflammation can increase the risk of depression. The dietary inflammatory index (DII) is a novel measure of dietary inflammation, which has been used to investigate the relationship between diet and mental disorders in adults. However, little research has been conducted to establish an association between dietary inflammation (as measured by DII) and postpartum depression (PPD) in exclusively breastfeeding women. (2) Methods: In this cross-sectional study, 293 women who were exclusively breastfeeding for 6 months or less were enrolled. The DII scores were evaluated using semi-quantitative Food Frequency Questionnaires (FFQ), and the Edinburgh Postpartum Depression Scale (EPDS) was used to measure depression levels of breastfeeding mothers during the six months following delivery. The participants were classified by tertiles, and the possibility of DII being associated with PPD was assessed by binary regression analysis. (3) Results: The average DII score was 2.32 ± 1.08, which ranged from -1.66 to 4.19. The rate of depression was 60.1%. Adjusted for potential risk factors such as age, educational level, occupational level, number of babies, number of caregivers, social support level, and sleep quality, the results showed that the lowest DII score was associated with a lower risk of PPD than the highest score (OR tertile Q1 vs. 3 = 0.47, 95% CI: 0.24, 0.93, p = 0.030). (4) Conclusions: In exclusive breastfeeding women, the inflammatory potential of dietary intake seems to be related to depression. Interventions to improve diet quality might consider including a dietary component that aims to lower chronic systemic inflammation to prevent PPD. However, the relationship between DII and PPD among Chinese women remains to be demonstrated in a larger population.
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Affiliation(s)
- Hanshuang Zou
- Department of Nutrition Science and Food Hygiene, Xiangya School of Public Health, Central South University, 110 Xiangya Rd, Changsha 410078, China
| | - Minghui Sun
- Department of Nutrition Science and Food Hygiene, Xiangya School of Public Health, Central South University, 110 Xiangya Rd, Changsha 410078, China
- Jining First People’s Hospital, Jining 272000, China
| | - Yan Liu
- Department of Child Care, Changsha Maternal and Child Health Care Hospital, 416 Chengnan East RD of Yuhua District, Changsha 410007, China
| | - Yue Xi
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510275, China
| | - Caihong Xiang
- Department of Nutrition Science and Food Hygiene, Xiangya School of Public Health, Central South University, 110 Xiangya Rd, Changsha 410078, China
| | - Cuiting Yong
- Department of Nutrition Science and Food Hygiene, Xiangya School of Public Health, Central South University, 110 Xiangya Rd, Changsha 410078, China
| | - Jiajing Liang
- Department of Nutrition Science and Food Hygiene, Xiangya School of Public Health, Central South University, 110 Xiangya Rd, Changsha 410078, China
| | - Jiaqi Huo
- Department of Nutrition Science and Food Hygiene, Xiangya School of Public Health, Central South University, 110 Xiangya Rd, Changsha 410078, China
| | - Qian Lin
- Department of Nutrition Science and Food Hygiene, Xiangya School of Public Health, Central South University, 110 Xiangya Rd, Changsha 410078, China
- Correspondence: (Q.L.); (J.D.); Tel.: +86-138-7482-0173 (Q.L.); +86-135-4864-3020 (J.D.)
| | - Jing Deng
- Department of Nutrition Science and Food Hygiene, Xiangya School of Public Health, Central South University, 110 Xiangya Rd, Changsha 410078, China
- Correspondence: (Q.L.); (J.D.); Tel.: +86-138-7482-0173 (Q.L.); +86-135-4864-3020 (J.D.)
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23
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Fu CY, Tang XJ, Pan LP, Jin HY, Yao JF, Wang LZ. Exclusive breastfeeding rate and related factors among mothers within maternal health WeChat groups in Jiaxing, Zhejiang province, China: a cross-sectional survey. Int Breastfeed J 2022; 17:80. [PMID: 36434642 PMCID: PMC9701072 DOI: 10.1186/s13006-022-00521-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Accepted: 11/11/2022] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND The health workers in Jiaxing of China have established maternal health WeChat groups for maternal health education and management since 2019. Pregnant women in Jiaxing are invited to join the WeChat groups and a health worker as the group manager provides health education and individual counselling for women within the group. This study aimed to investigate the exclusive breastfeeding (EBF) status up to six months and its associated factors among the mothers of infants aged 7-12 months within the WeChat groups. METHODS This was a cross-sectional survey on healthy mothers with infants aged 7-12 months from seven maternal health WeChat groups in October 2021 in Jiaxing, China. EBF was defined as breastfeeding infants exclusively up to six months. Data including breastfeeding practice from birth to six months, maternal sociodemographic and obstetric characteristics, hospitalization information, work related factors and reasons for non-EBF up to six months were collected using an online self-administered questionnaire. A multivariable logistic regression analysis was performed to identify the factors independently associated with EBF up to 6 months. RESULTS A total of 822 mothers were included in this study. Among them, 586 mothers (71.3%) exclusively breastfed infants up to six months. Multivariable logistic regression analysis showed that older maternal age (adjusted odds ratio [AOR] 0.956; 95% confidence interval [CI] 0.917, 0.997) and perceived insufficient breast milk (AOR 0.104; 95% CI 0.072, 0.149) were associated with lower odds of EBF up to six months. The five of common reasons for non-EBF up to six months were no or insufficient breast milk (59.8%), return to work (23.9%), no flexible nursing breaks at work (18.2 %), infant crying or feeling tired or troubled with breastfeeding (9.7%), and nipple and breast problems (9.3%). CONCLUSION About 71.3% of infants were exclusively breastfed until six months of age in our WeChat groups. Perceived insufficient breast milk and work related factors are the main barriers to EBF up to six months in this setting. However, further comparative study is needed to confirm the effect of WeChat groups on breastfeeding.
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Affiliation(s)
- Chun-Yan Fu
- grid.411870.b0000 0001 0063 8301Department of Maternal Health, Jiaxing Maternity and Children Health Care Hospital, Affiliated Women and Children Hospital, Jiaxing University, Jiaxing, Zhejiang Province China
| | - Xue-Juan Tang
- grid.411870.b0000 0001 0063 8301Department of Maternal Health, Jiaxing Maternity and Children Health Care Hospital, Affiliated Women and Children Hospital, Jiaxing University, Jiaxing, Zhejiang Province China
| | - Ling-Pei Pan
- Department of Maternal Health, Jiaxing Xiuzhou Maternity and Children Health Care Hospital, Jiaxing, Zhejiang Province China
| | - Hai-Ying Jin
- Department of Public Health, Jiashan Maternity and Children Health Care Hospital, Jiaxing, Zhejiang Province China
| | - Juan-Feng Yao
- Department of Maternal Health, Tongxiang Maternity and Children Health Care Hospital, Jiaxing, Zhejiang Province China
| | - Li-Zhong Wang
- grid.411870.b0000 0001 0063 8301Department of Anesthesiology, Jiaxing Maternity and Children Health Care Hospital, Affiliated Women and Children Hospital, Jiaxing University, Jiaxing, Zhejiang Province China
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24
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Shing JS, Lok KY, Fong DY, Fan HS, Chow CL, Tarrant M. The Influence of the Baby-Friendly Hospital Initiative and Maternity Care Practices on Breastfeeding Outcomes. J Hum Lact 2022; 38:700-710. [PMID: 35403491 DOI: 10.1177/08903344221086975] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND The Baby-Friendly Hospital Initiative (BFHI) was launched in 1991 to promote breastfeeding through hospital policy. Researchers have reported breastfeeding improvements after hospitals became "Baby-Friendly." In Hong Kong, the first public hospital was designated as a Baby-Friendly Hospital in 2016. RESEARCH AIM To examine the influence of the BFHI on breastfeeding by comparing breastfeeding outcomes in a study cohort recruited before the implementation of the BFHI and a cohort recruited after its implementation. METHODS This was a quasi-experimental interrupted time-series design. Two cohorts of mother-infant pairs (N = 2369) were recruited immediately postpartum from four public hospitals in Hong Kong and followed up prospectively. Comparisons were made in five of the BFHI steps experienced in both cohorts and the duration of any and exclusive breastfeeding. RESULTS A higher proportion of participants from the post-implementation cohort breastfed and breastfed exclusively at all follow-up periods. Participants in the pre-BFHI cohort, on average experienced 3.10 (SD = 1.42) of the BFHI steps, whereas the participants in the post-BFHI cohort experienced 3.59 (1.09) of the BFHI steps. Half of the participants discontinued any breastfeeding by 13 weeks in the pre-BFHI cohort; more than half in the post-BFHI cohort were still breastfeeding at 6 months postpartum (p < .001). Giving only human milk in the first 48 hr of delivery and not providing pacifiers or bottles were associated with lower risk of not exclusive breastfeeding in both cohorts. CONCLUSION Implementation of the BFHI was associated with improvements in breastfeeding practices and outcomes.
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Affiliation(s)
- Jeffery Sy Shing
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong
| | - Kris Yw Lok
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong
| | - Daniel Yt Fong
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong
| | - Heidi Sl Fan
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong
| | - Charlotte Ly Chow
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong
| | - Marie Tarrant
- School of Nursing, The University of British Columbia, Kelowna, BC, Canada
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25
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Hao Y, Wang L, Wang C, Peng A, Gao W, Marc I, Semenic S, Fraser WD, Narayan A, Wu Y, Chang S, Huang H. Breastfeeding Practices and Associated Factors in Shanghai: A Cross-Sectional Study. Nutrients 2022; 14:nu14204429. [PMID: 36297120 PMCID: PMC9610171 DOI: 10.3390/nu14204429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 10/14/2022] [Accepted: 10/16/2022] [Indexed: 11/18/2022] Open
Abstract
The status of breastfeeding practices remains unsatisfactory across China, but regional differences persist. However, disaggregated data for specific provinces are limited. This representative survey determined the status of breastfeeding and factors associated with breastfeeding practices in Shanghai. The questionnaire was designed in compliance with indicators for assessing infant and young child-feeding practices defined by the World Health Organization and the United Nations Children's Fund (UNICEF). A total of 2665 children aged two years and younger (0-730 days) were investigated, among whom 1677 were aged under six months. The early initiation of breastfeeding (EIBF) rate was 60.3%. Among children aged under six months, 43.4% were exclusively breastfed (EBF). The univariate regression analysis showed that the EBF rate was influenced by multiple factors, including individual, socioeconomic, workplace and employment, and health system. The subsequent multivariate analysis suggested that mothers with a higher rate of EBF shared the following characteristics: intention to breastfeed during pregnancy, breastfeeding knowledge, and higher satisfaction with support through the healthcare system after delivery. The rate of EBF in Shanghai is over 40%, and supporting breastfeeding requires measures at multiple levels, including individual attributes, women's work and employment conditions, breastfeeding knowledge, and health services.
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Affiliation(s)
- Yanhui Hao
- Obstetrics and Gynecology Hospital, Institute of Reproduction and Development, Fudan University, Shanghai 200032, China
| | - Lulu Wang
- Obstetrics and Gynecology Hospital, Institute of Reproduction and Development, Fudan University, Shanghai 200032, China
| | - Caifeng Wang
- School of Nursing, Shanghai Jiao Tong University, Shanghai 200025, China
| | - Aiping Peng
- The International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200030, China
| | - Wei Gao
- The International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200030, China
| | - Isabelle Marc
- Department of Pediatrics, Research Center of CHU de Québec-Université Laval, Faculty of Medicine, Laval University, Québec, QC G1V 0A6, Canada
| | - Sonia Semenic
- Ingram School of Nursing, McGill University, Montréal, QC H3A 0G4, Canada
| | - William D. Fraser
- Department of Obstetrics and Gynecology, Université de Sherbrooke, Sherbrooke, QC J1K 2R1, Canada
| | - Anuradha Narayan
- United Nations Children’s Fund, Office for China, Beijing 100600, China
| | - Yanting Wu
- Obstetrics and Gynecology Hospital, Institute of Reproduction and Development, Fudan University, Shanghai 200032, China
- Correspondence: (Y.W.); (S.C.); (H.H.)
| | - Suying Chang
- United Nations Children’s Fund, Office for China, Beijing 100600, China
- Correspondence: (Y.W.); (S.C.); (H.H.)
| | - Hefeng Huang
- Obstetrics and Gynecology Hospital, Institute of Reproduction and Development, Fudan University, Shanghai 200032, China
- The International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200030, China
- Research Units of Embryo Original Diseases, Chinese Academy of Medical Sciences (No. 2019RU056), Shanghai 200011, China
- Correspondence: (Y.W.); (S.C.); (H.H.)
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Evidence from a Choice Experiment in Consumer Preference towards Infant Milk Formula (IMF) in the Context of Dairy Revitalization and COVID-19 Pandemic. Foods 2022; 11:foods11172689. [PMID: 36076874 PMCID: PMC9455783 DOI: 10.3390/foods11172689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 08/28/2022] [Accepted: 09/01/2022] [Indexed: 11/30/2022] Open
Abstract
China is the largest global consumer of infant milk formula (IMF). Chinese consumer preferences towards IMF have evolved over time but have also been rocked in recent years by COVID-19 with major implications for the IMF industry, globally and within China. This study is the first to document parents’ preferences toward IMF since the outbreak. We used novel methods to do so, through an online choice experiment of 804 participants that included risk perceptions and socio-demographic variables. Our study finds that Chinese parents continue to prioritize quality and safety attributes of IMF represented by functional ingredients, organic labelling and traceability information. Notably, it also finds greatly increased confidence in Chinese domestically produced IMF and an underlying preference away from expensive products. This implies that the era of ‘go for foreign’ and ‘go for the most expensive’ in IMF purchasing may be coming to an end. The shift in sentiment is driven by the longer-term revitalization of the Chinese dairy industry, accelerated by COVID-19. Understanding these trends will be of major benefit to both Chinese producers and non-Chinese exporters of IMF.
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Jiang M, Ren G, Dai H, Tian L, Huang J, He W, Tan S. Comparation of knowledge, attitude and social support of exclusive breastfeeding between primiparae and multiparae after delivery within 6 months in Changsha, China: a cross-sectional study. Transl Pediatr 2022; 11:1323-1335. [PMID: 36072543 PMCID: PMC9442209 DOI: 10.21037/tp-22-327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Accepted: 08/02/2022] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND The knowledge, attitude, and social support of exclusive breastfeeding among mothers are the important predictors of the starting time of lactation and the duration time of breastfeeding. Evaluating the knowledge, attitude, social support of exclusive breastfeeding of mothers is critical to recognize those at risk for suboptimal breastfeeding practices. There were a small amount of studies related to knowledge, attitude and social support of mothers, a blank for comparative study of the knowledge, attitude, social support of breastfeeding between primiparae and multiparae existed. Our aim was to compare the feeding situation between firstborns and second-born infants, and to compare the knowledge, attitude, and social support between primiparae and multiparae. METHODS This was a cross-sectional study, a total of 354 mothers of infants aged 0-6 months who underwent physical examination between February 2019 and July 2019 were randomly recruited to the study and finished an on-site questionnaire. Chi-square test or Fisher's exact test were used to make a comparison among groups. RESULTS The average rate of exclusive breastfeeding among infants aged 0-6 months was 61.30%. There is no statistical difference between the firstborns and the second-born infants regarding whether cod liver oil was supplemented, whether it was breastfeeding after birth, the signal of breastfeeding for infants, and the duration of each lactation (P>0.05); The rate of exclusive breastfeeding of second-born infants was lower than that of firstborns (P=0.001); The starting time of breastfeeding of second-born infants was earlier than that of firstborns (P=0.041). Compared to primiparae, multiparae had a higher degree of understanding of feeding knowledge (P<0.001), a higher proficiency level of self-evaluation of feeding techniques (P<0.001); and a better self-evaluation of feeding habit (P<0.001); more multiparae had prenatal feeding counselling (P<0.001); primiparae and multiparae had no statistical difference in attitude and social support of breastfeeding (all P>0.05). CONCLUSIONS Breastfeeding knowledge, skills, and habits of mothers all need to be improved. It's urgent to make up for the deficiency of news media such as television and radio in the dissemination of breastfeeding knowledge. Primiparas with a high level of education are the key object of our publicity and education.
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Affiliation(s)
- Mei Jiang
- Nursing Department, The Third Xiangya Hospital of Central South University, Changsha, China
| | - Guofeng Ren
- Department of Nutrition and Food Hygiene, Xiangya Public Health School of Central South University, Changsha, China
| | - Hongmei Dai
- Department of Pediatrics, The Third Xiangya Hospital of Central South University, Changsha, China
| | - Lang Tian
- Department of Pediatrics, The Third Xiangya Hospital of Central South University, Changsha, China
| | - Jinhui Huang
- Nursing Department, The Third Xiangya Hospital of Central South University, Changsha, China
| | - Wei He
- Nursing Department, The Third Xiangya Hospital of Central South University, Changsha, China
| | - Shan Tan
- Department of Pediatrics, The Third Xiangya Hospital of Central South University, Changsha, China
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Liu J, Gao D, Li Y, Chen M, Wang X, Ma Q, Ma T, Chen L, Ma Y, Zhang Y, Ma J, Dong Y. Breastfeeding Duration and High Blood Pressure in Children and Adolescents: Results from a Cross-Sectional Study of Seven Provinces in China. Nutrients 2022; 14:3152. [PMID: 35956332 PMCID: PMC9370455 DOI: 10.3390/nu14153152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 07/24/2022] [Accepted: 07/28/2022] [Indexed: 11/16/2022] Open
Abstract
This study was aimed to investigate the associations between breastfeeding duration and blood pressure (BP) levels, BP Z scores and high BP (HBP) in children and adolescents. A total of 57,201 participants including 29,491 boys and 27,710 girls aged 7−18 years were recruited from seven provinces in China in 2012. HBP was defined as BP levels of ≥95th percentiles of the referent age-, sex-, and height-specific population. Breastfeeding duration was divided into non-breastfeeding, 0−5 months, 6−12 months, and >12 months. Information on demographic, parental or family factors and dietary behaviors was collected through a self-administered questionnaire. Multivariable linear regression and logistic regression models were applied to assess the relationships of breastfeeding duration with BP levels and BP Z scores and with HBP, respectively. Stratified analyses were performed to further investigate the potential subgroup-specific associations. The reported prolonged breastfeeding (>12 months) rate was 22.53% in the total population. After full adjustment, compared to the non-breastfeeding group, breastfeeding for 6−12 months was correlated with 0.43 (95% CI: −0.75, −0.11) and 0.36 (95% CI: −0.61, −0.12) mmHg lower levels of SBP and DBP, respectively. Similar decrease trends were found for BP Z scores. Prolonged breastfeeding (>12 months) was associated with 1.33 (95% CI: 1.12, 1.58) and 1.12 (95% CI: 0.94, 1.33) higher odds of HBP in boys and girls, respectively. Based on nationally representative data, there was no evidence that a longer duration of breastfeeding is protective against childhood HBP. Breastfeeding for 6−12 months may be beneficial to BP, while prolonged breastfeeding durations might increase the odds of HBP in children and adolescents.
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Affiliation(s)
- Jieyu Liu
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing 100191, China; (J.L.); (D.G.); (Y.L.); (M.C.); (Q.M.); (T.M.); (L.C.); (Y.M.); (Y.Z.)
- National Health Commission Key Laboratory of Reproductive Health, Beijing 100191, China
| | - Di Gao
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing 100191, China; (J.L.); (D.G.); (Y.L.); (M.C.); (Q.M.); (T.M.); (L.C.); (Y.M.); (Y.Z.)
- National Health Commission Key Laboratory of Reproductive Health, Beijing 100191, China
| | - Yanhui Li
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing 100191, China; (J.L.); (D.G.); (Y.L.); (M.C.); (Q.M.); (T.M.); (L.C.); (Y.M.); (Y.Z.)
- National Health Commission Key Laboratory of Reproductive Health, Beijing 100191, China
| | - Manman Chen
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing 100191, China; (J.L.); (D.G.); (Y.L.); (M.C.); (Q.M.); (T.M.); (L.C.); (Y.M.); (Y.Z.)
- National Health Commission Key Laboratory of Reproductive Health, Beijing 100191, China
| | - Xinxin Wang
- School of Public Health and Management, Ningxia Medical University, Yinchuan 750004, China;
| | - Qi Ma
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing 100191, China; (J.L.); (D.G.); (Y.L.); (M.C.); (Q.M.); (T.M.); (L.C.); (Y.M.); (Y.Z.)
- National Health Commission Key Laboratory of Reproductive Health, Beijing 100191, China
| | - Tao Ma
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing 100191, China; (J.L.); (D.G.); (Y.L.); (M.C.); (Q.M.); (T.M.); (L.C.); (Y.M.); (Y.Z.)
- National Health Commission Key Laboratory of Reproductive Health, Beijing 100191, China
| | - Li Chen
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing 100191, China; (J.L.); (D.G.); (Y.L.); (M.C.); (Q.M.); (T.M.); (L.C.); (Y.M.); (Y.Z.)
- National Health Commission Key Laboratory of Reproductive Health, Beijing 100191, China
| | - Ying Ma
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing 100191, China; (J.L.); (D.G.); (Y.L.); (M.C.); (Q.M.); (T.M.); (L.C.); (Y.M.); (Y.Z.)
- National Health Commission Key Laboratory of Reproductive Health, Beijing 100191, China
| | - Yi Zhang
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing 100191, China; (J.L.); (D.G.); (Y.L.); (M.C.); (Q.M.); (T.M.); (L.C.); (Y.M.); (Y.Z.)
- National Health Commission Key Laboratory of Reproductive Health, Beijing 100191, China
| | - Jun Ma
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing 100191, China; (J.L.); (D.G.); (Y.L.); (M.C.); (Q.M.); (T.M.); (L.C.); (Y.M.); (Y.Z.)
- National Health Commission Key Laboratory of Reproductive Health, Beijing 100191, China
| | - Yanhui Dong
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing 100191, China; (J.L.); (D.G.); (Y.L.); (M.C.); (Q.M.); (T.M.); (L.C.); (Y.M.); (Y.Z.)
- National Health Commission Key Laboratory of Reproductive Health, Beijing 100191, China
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Zhang Y, Gao Y, He X, Ding S, Gao H. Oral Lactobacillus fermentum CECT5716 in the patients with lactational abscess treated by needle aspiration: The late follow-up of a randomized controlled trial. Medicine (Baltimore) 2022; 101:e29761. [PMID: 35777008 PMCID: PMC9239655 DOI: 10.1097/md.0000000000029761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Lactational mastitis and breast abscess cause trouble for women. It has been shown that oral probiotics can improve breast microecology, thus alleviating inflammatory responses. Our study aims to understand the long-term effect of Lactobacillus fermentum CECT5716 on patients with lactational breast abscess after needle aspiration. METHODS Data continued in a randomized controlled study of 101 subjects with lactational abscess from 12 hospitals were included. They were randomly divided into an experimental group and a control group. After needle aspiration treatment, the experimental group was orally administrated with L fermentum CECT5716 for 4 consecutive weeks, while the control group was treated with maltodextrin in the same way). In the third month after randomized controlled trial, the subjects were followed up by an online questionnaire investigation. The observation indexes included the relief of breast pain, recurrence of mastitis from the end of oral administration to the follow-up, and the effect on continuing breastfeeding. RESULTS A total of 101 patients were enrolled and 83 valid questionnaires were received during follow-up, including 40 in the experimental group and 43 in the control group. The rate of stop breastfeeding due to recurrence of mastitis was 2.5% (1/40) in the experimental group and 18.6% (8/43) in the control group, with a statistically significant difference (odds ratio = 0.112, 95% confidence interval: 0.013-0.942, P < .05). The rate of stop breastfeeding was 10% (4/40) in the experimental group and 25.6% (11/43) in the control group, without significant difference. The pain relief rate in the experimental group was 80% (32/40), which showed no significant difference from that in the control group, that is, 72.1% (31/43). The recurrence rate of mastitis in the experimental group was 20% (8/40), which was not significantly different from that in the control group, that is, 16.3% (7/43). CONCLUSIONS In lactating women with a history of breast abscess, oral L fermentum CECT5716 may reduce the risk of stop breastfeeding due to recurrence of mastitis.
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Affiliation(s)
- Yi Zhang
- Department of Breast Surgery, Maternal and Child, Center for Prevention and Cure of Breast Diseases, Haidian Maternal and Child Health Hospital, Haidian District, Beijing, China
| | - Yajun Gao
- Department of Breast Surgery, Maternal and Child, Center for Prevention and Cure of Breast Diseases, Haidian Maternal and Child Health Hospital, Haidian District, Beijing, China
- *Correspondence: Yajun Gao, MBBS, Department of Breast Surgery, Maternal and Child, Center for Prevention and Cure of Breast Diseases, Haidian Maternal and Child Health Hospital, Haidian District, Beijing 100080, China (e-mail: )
| | - Xiangping He
- Department of Breast Surgery, Maternal and Child, Center for Prevention and Cure of Breast Diseases, Haidian Maternal and Child Health Hospital, Haidian District, Beijing, China
| | - Songtao Ding
- Department of Breast Surgery, Maternal and Child, Center for Prevention and Cure of Breast Diseases, Haidian Maternal and Child Health Hospital, Haidian District, Beijing, China
| | - Haifeng Gao
- Department of Breast Surgery, Maternal and Child, Center for Prevention and Cure of Breast Diseases, Haidian Maternal and Child Health Hospital, Haidian District, Beijing, China
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30
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Liu A, Zhang J, Wu Q, Zhang Y, van Velthoven M. Comparison of the agreement between WeChat-based self-administered and interviewer-administered data on infant and young child feeding in China: A test-retest study. J Glob Health 2022; 12:11004. [PMID: 35726544 PMCID: PMC9210156 DOI: 10.7189/jogh.12.11004] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
Background Measuring infant and young child feeding (IYCF) indicators is important in evaluating child health programs and making evidence-based decisions. With Internet and new media rapidly developing, communication apps such as WeChat (the most popular mobile social media platform in China) are widely used and can potentially be used as an alternative way to collect infant and young child feeding information. This study compares data agreement between a WeChat-based self-administered and an interviewer-administered survey on infant and young child feeding information. Methods We recruited 297 mothers of children aged 6-23 months in Fenxi County, Shanxi Province, China. Using the Test-Retest method, we first collected data through a self-administered survey using a WeChat-based electronic questionnaire and asked 36 questions on breastfeeding and complementary feeding knowledge, practices, and information sources. We then conducted an interviewer-administered survey using the same questionnaire and compared the data agreement between the two survey methods during the same day. Cohen's kappa score (κ) and intraclass correlation coefficients (ICC) were used for data agreement analysis for all 36 questions and six key IYCF indicators. The McNemar test was used to identify differences between the two survey methods for the six key indicators. Results There was substantial or almost perfect agreement for 33 questions (κ/ICC>0.60), and slight or fair agreement for the other 3 questions (κ/ICC<0.40). Agreement of all six key IYCF indicators was substantial or almost perfect (κ = 0.78-0.94), while two indicators showed statistical differences between the two survey methods (P = 0.03 for “Minimum meal frequency” and P = 0.001 for “Minimum accepted diet”). Analysis of reasons for inconsistencies showed that 43.6% of all the inconsistencies were not caused by the self-administered survey method. The cost of the interviewer-administered survey was much higher than that of the self-administered survey: ¥45.9 (US$6.8) vs ¥19.7 (US$2.9) per questionnaire. Conclusions The WeChat-based self-administered method can be used for future data collection of infant and young child feeding information in China. Most of the questions and key indicators showed very good agreement without statistical differences between the two methods.
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Affiliation(s)
- Aihua Liu
- Department of Integrated Early Childhood Development, Capital Institute of Pediatrics, Beijing, China
| | - Jian Zhang
- Department of Integrated Early Childhood Development, Capital Institute of Pediatrics, Beijing, China
| | - Qiong Wu
- Department of Integrated Early Childhood Development, Capital Institute of Pediatrics, Beijing, China
| | - Yanfeng Zhang
- Department of Integrated Early Childhood Development, Capital Institute of Pediatrics, Beijing, China
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Sirkka O, Abrahamse-Berkeveld M, van der Beek EM. Complementary Feeding Practices among Young Children in China, India, and Indonesia: A Narrative Review. Curr Dev Nutr 2022; 6:nzac092. [PMID: 35769448 PMCID: PMC9233619 DOI: 10.1093/cdn/nzac092] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 03/24/2022] [Accepted: 04/27/2022] [Indexed: 11/21/2022] Open
Abstract
Under- and overnutrition are co-existing health issues in several countries across Asia. Poor complementary feeding (CF) is a significant determinant of malnutrition in children and a major cause of morbidity and mortality. The purpose of this narrative review is to summarize the most recent evidence regarding the CF practices in 3 countries with a high prevalence of stunting and overweight, and currently undergoing rapid economic and nutritional transition: China, India, and Indonesia. We focused particularly on the adequacy of CF, based on the WHO feeding indicators (2021) regarding timing, frequency, diversity, as well as the consumption of specific food groups. According to the findings, the majority of infants in the 3 countries are introduced to CF at an inappropriate time: either too early (particularly in urban/rural areas of China and Indonesia) or too late (India) compared with the WHO recommendation. Furthermore, in all countries, diets are characterized by a low variety and frequency of CF and consist mainly of staple foods with poor nutritional quality, such as rice, cereals, or noodles. Nutrient-dense and protein-rich foods, such as foods of animal origin, are either inadequately consumed (rural areas of China and India) or introduced too late (urban areas of China and Indonesia) in the diets of children. In all countries, the consumption of fruit and vegetables, especially during the early CF period, is poor. In contrast, a significant proportion of both urban and rural children, particularly in Indonesia and India, are consuming energy-dense/nutrient-poor snacks and sugary drinks during the CF period. The described practices may pose a significant risk for the development of energy and/or nutrient gaps, magnifying the double and triple burden of malnutrition present in these countries. Further research is warranted to understand the significance of the observed practices for stunting and/or overweight/obesity risk.
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Affiliation(s)
- Outi Sirkka
- Danone Nutricia Research, Utrecht, The Netherlands
| | | | - Eline M van der Beek
- Department of Pediatrics, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
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Duan Y, Yang Z, Bi Y, Wang J, Pang X, Jiang S, Zhang H, Xu L, Lai J. What are the determinants of low exclusive breastfeeding prevalence in China? A cross‐sectional study. MATERNAL & CHILD NUTRITION 2022; 18:e13324. [PMID: 35137523 PMCID: PMC8932722 DOI: 10.1111/mcn.13324] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Revised: 12/18/2021] [Accepted: 01/04/2022] [Indexed: 11/26/2022]
Abstract
Exclusive breastfeeding (EBF) status is far from the national target in China. To identify the modifiable factors associated with EBF of infants aged under 6 months in China. A cross‐sectional study was conducted in 12 provinces/municipalities across China in 2017–2018. We used multistage stratified cluster sampling and collected data through face‐to‐face interviews with mothers using an electronic questionnaire. Totally, 5287 pairs of mother–infant aged <6 months were investigated. The EBF prevalence was 29.2% (1544/5287). Mothers with correct knowledge of colostrum (adjusted odds ratio [AOR]:1.32, 95% confidence interval [CI]: 1.07, 1.62), EBF (AOR: 1.39, 95% CI: 1.06, 1.81) and the highest scores of perceptions for breastfeeding benefits (AOR: 1.36, 95% CI: 1.14, 1.61) were more likely to exclusively breastfeed. However, mothers with more frequent unwillingness of breastfeeding during the first month postpartum were less likely to practice EBF (AOR: 0.68, 95% CI: 0.52, 0.90). Infants having their first breast milk within 24 h of birth increased the odds of EBF (AOR: 2.41, 95% CI: 1.86, 3.13). Infants were less likely to be exclusively breastfed in the families in which the main caregiver was the grandmothers. Mothers without receiving infant formula feeding suggestions via the health facilities, media, or the Internet (AOR: 1.57, 95% CI: 1.33, 1.85) or without the experience of infant formula feeding in public (AOR: 1.45, 95% CI: 1.23, 1.72) might more likely to practice EBF. To acquire comprehensively correct knowledge and keep a positive attitude of breastfeeding for the mothers are crucial for improving the EBF prevalence. Family supports are potential interventions worth focusing on. Infant formula promotion remains a great barrier for EBF in China.
This is the first study with a large sample size that examined determinants at individual, family, community and social levels potentially affecting EBF practice in China. In this cross‐sectional study, mothers with completely correct knowledge and positive attitude of breastfeeding, infants having their first breast milk within 24 h of birth, and without exposure to infant formula feeding suggestions or experience might more likely to practice EBF. Dissemination of comprehensively correct knowledge and operational skills of breastfeeding, initiation of breastfeeding as soon as possible, reducing the influence of infant formula might be effective methods for improving the EBF prevalence in China.
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Affiliation(s)
- Yifan Duan
- Key Laboratory of Trace Element Nutrition of National Health and Family Planning Commission, National Institute for Nutrition and Health Chinese Center for Disease Control and Prevention Beijing China
| | - Zhenyu Yang
- Key Laboratory of Trace Element Nutrition of National Health and Family Planning Commission, National Institute for Nutrition and Health Chinese Center for Disease Control and Prevention Beijing China
| | - Ye Bi
- Key Laboratory of Trace Element Nutrition of National Health and Family Planning Commission, National Institute for Nutrition and Health Chinese Center for Disease Control and Prevention Beijing China
| | - Jie Wang
- Key Laboratory of Trace Element Nutrition of National Health and Family Planning Commission, National Institute for Nutrition and Health Chinese Center for Disease Control and Prevention Beijing China
| | - Xuehong Pang
- Key Laboratory of Trace Element Nutrition of National Health and Family Planning Commission, National Institute for Nutrition and Health Chinese Center for Disease Control and Prevention Beijing China
| | - Shan Jiang
- Key Laboratory of Trace Element Nutrition of National Health and Family Planning Commission, National Institute for Nutrition and Health Chinese Center for Disease Control and Prevention Beijing China
| | - Huanmei Zhang
- Key Laboratory of Trace Element Nutrition of National Health and Family Planning Commission, National Institute for Nutrition and Health Chinese Center for Disease Control and Prevention Beijing China
| | - Lili Xu
- Institute for the Prevention and Control of Chronic Non Communicable Diseases Heilongjiang Provincial Center for Disease Control and Prevention Harbin Heilongjiang China
| | - Jianqiang Lai
- Key Laboratory of Trace Element Nutrition of National Health and Family Planning Commission, National Institute for Nutrition and Health Chinese Center for Disease Control and Prevention Beijing China
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Han S, Chen H, Wu Y, Pérez‐Escamilla R. Content analysis of breast milk substitutes marketing on Chinese e‐commerce platforms. MATERNAL & CHILD NUTRITION 2022; 18:e13332. [PMID: 35213768 PMCID: PMC8932694 DOI: 10.1111/mcn.13332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 12/16/2021] [Accepted: 01/26/2022] [Indexed: 11/28/2022]
Affiliation(s)
- Shannon Han
- Department of Social and Behavioral Sciences, Laboratory of Epidemiology and Public Health, Yale School of Public Health Yale University New Haven Connecticut USA
| | - Huixi Chen
- International Peace Maternity and Child Health Hospital Shanghai Jiaotong University School of Medicine Shanghai China
| | - Yanting Wu
- Obstetrics and Gynecology Hospital, Institute of Reproduction and Development Fudan University Shanghai China
| | - Rafael Pérez‐Escamilla
- Department of Social and Behavioral Sciences, Laboratory of Epidemiology and Public Health, Yale School of Public Health Yale University New Haven Connecticut USA
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Wu Q, Tang N, Wacharasin C. Factors influencing exclusive breastfeeding for 6 months postpartum: A systematic review. Int J Nurs Knowl 2022; 33:290-303. [PMID: 35088945 DOI: 10.1111/2047-3095.12360] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Accepted: 01/11/2022] [Indexed: 11/28/2022]
Abstract
PURPOSE This systematic review aims to identify factors influencing exclusive breastfeeding (EBF) up to 6 months. METHODS The databases including PubMed, MEDLINE, CINAHL, Scopus, EMBASE, CNKI, and WANFANG were searched to retrieve studies. Quantitative research were extracted and the preferred reporting items for systematic reviews were followed. Critical appraisal checklists of Joanna Briggs Institute were used to evaluate the quality of the included studies. FINDINGS A total of 16 papers were eligible for this systematic review, comprising five cohort studies and 11 cross-sectional studies. Moderate to strong evidence supported that 6-month exclusive breastfeeding is affected by maternal working status, breastfeeding knowledge, delivery mode, parity, perception of insufficient human milk, mothers' infant feeding attitude, breastfeeding self-efficacy, and intention. CONCLUSIONS Factors influencing EBF up to 6 months postpartum play a key role in promoting mothers' health and reducing diseases in their infants. IMPLICATIONS FOR NURSING PRACTICE Interventions based on related factors should be developed and taken into practice to assist mothers in exclusive breastfeeding for up to 6 months. Additional studies from different countries in different populations with high quality are needed to provide more reliable and richer findings.
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Affiliation(s)
- Qian Wu
- Faculty of Nursing, Jiangsu Vocational College of Medicine, Jiangsu, P. R. China.,Faculty of Nursing, Burapha University, Chon Buri, Thailand
| | - Nan Tang
- Faculty of Nursing, Jiangsu Vocational College of Medicine, Jiangsu, P. R. China.,Faculty of Nursing, Burapha University, Chon Buri, Thailand
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Dwivedi S, Sarfarj M, Ansari F, Singh S, Yaqoob A, Kumar S. Evaluation of mother's complementary feeding knowledge and occlusion. JOURNAL OF PHARMACY AND BIOALLIED SCIENCES 2022; 14:S872-S875. [PMID: 36110666 PMCID: PMC9469288 DOI: 10.4103/jpbs.jpbs_33_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 03/19/2022] [Accepted: 03/23/2022] [Indexed: 11/30/2022] Open
Abstract
Aim: Mothers' understanding of feeding methods and how they affect deciduous dentition were the focus of this study. Materials and Methods: This study looked at people from different parts of the population. In total, 230 moms of children aged 6 months to 5 years who completed an oral health questionnaire were included in the study. Mothers' awareness of feeding patterns and their impact on deciduous dentition were examined in the study. Results: Illiterate moms' children showed a significant difference in the quality of their occlusion compared to similarly raised children of literate mothers. Children who began supplementary feeding before the age of 6 months were more likely to have occlusion changes. Conclusion: Malocclusion prevalence was shown to be unrelated to meal behaviors. However, further research is required as there are just a few studies currently available.
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Yao S, Xiao S, Jin X, Xiong M, Peng J, Jian L, Mei Y, Huang Y, Zhou H, Xu T. Effect of a community-based child health counselling intervention on health-seeking behaviours, complementary feeding and nutritional condition among children aged 6-23 months in rural China: A pre- and post-comparison study. MATERNAL & CHILD NUTRITION 2022; 18:e13289. [PMID: 34816596 PMCID: PMC8710108 DOI: 10.1111/mcn.13289] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 10/08/2021] [Accepted: 10/11/2021] [Indexed: 11/28/2022]
Abstract
In China, the prevalence of undernutrition among children under 5 years of age has declined significantly during recent decades. However, noticeable gaps exist between rural and urban areas. Since 2012, a government-funded nutrition programme, Ying Yang Bao (YYB; soybean powder-based iron-rich supplement) programme, has been implemented in poor rural areas to decrease the risk of developing anaemia among children aged 6-23 months, but there are still inadequate health care awareness, feeding knowledge and skills among caregivers. From June 2018 to December 2020, a child health counselling intervention was delivered through a home visit based on the YYB programme in Liangshan. Child health messages were given by trained village child health assistants while distributing YYB. Surveys were conducted before and after the intervention to analyse changes in child health check-up frequency, complementary feeding practice and prevalence of undernutrition. After the intervention, the proportion of children who had regular health check-ups, who were vaccinated and who met the minimum YYB consumption significantly increased from 26.0%, 81.6%, and 67.8% to 59.7%, 95.0%, and 79.2%. Increased rates of IYCF indicators (introduction of solid, semisolid, or soft foods, minimum dietary diversity and consumption of iron-rich or iron-fortified foods) were observed after the intervention. The prevalence of stunting, underweight, wasting, and anaemia significantly decreased from 26.3% to 10.8%, 13.4% to 8.7%, 14.0% to 10.5%, and 52.1% to 43.9%. This intervention can be well integrated into the YYB programme with less additional resources. Children in resource-limited areas will benefit more from a comprehensive nutritional package, including food supplements and child health education.
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Affiliation(s)
- Shiyi Yao
- Child Health Care Department, National Center for Women and Children's Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Shuyue Xiao
- Child Health Care Department, National Center for Women and Children's Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Xi Jin
- Child Health Care Department, National Center for Women and Children's Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Mei Xiong
- Division of Program Management, Liangshan Yi Autonomous Prefecture Hospital for Women and Children's Health, Sichuan, China
| | - Jing Peng
- Division of Program Management, Liangshan Yi Autonomous Prefecture Hospital for Women and Children's Health, Sichuan, China
| | - Lijun Jian
- Child Health Care Department, Butuo County Hospital for Women and Children's Health, Sichuan, China
| | - Yongli Mei
- Division of Program Management, Meigu County Hospital for Women and Children's Health, Sichuan, China
| | - Yuehua Huang
- Child Health Care Department, Yuexi County Hospital for Women and Children's Health, Sichuan, China
| | - Haiqun Zhou
- Child Health Care Department, Zhaojue County Hospital for Women and Children's Health, Sichuan, China
| | - Tao Xu
- Child Health Care Department, National Center for Women and Children's Health, Chinese Center for Disease Control and Prevention, Beijing, China
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Fang Y, Lian Y, Yang Z, Duan Y, He Y. Associations between Feeding Patterns and Infant Health in China: A Propensity Score Matching Approach. Nutrients 2021; 13:4518. [PMID: 34960071 PMCID: PMC8706916 DOI: 10.3390/nu13124518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 12/10/2021] [Accepted: 12/15/2021] [Indexed: 11/16/2022] Open
Abstract
Breastmilk is the optimal food for infants. Feeding pattern is closely related to physical development and health during infancy. Understanding the associations between feeding patterns and health status can inform related policy interventions and advocacy in China. This study aimed to investigate the relationship between infant feeding patterns and health status in China infants. The China National Nutrition and Health Surveillance 2013 was a national-representative cross-sectional study performed particularly for children aged 0-5 years. A total of 3974 infants aged under 1 year were included in the analysis, of whom 1082 (27.2%) made up the formula feeding group, and 2892 (72.8%) made up the breastfeeding group. The associations between feeding patterns and physical development and health were investigated using propensity score matching and multivariable logistic regression models. Among breastfeeding and formula feeding infants aged 9-11 months old, weight-for-age z score was 1.1 ± 1.1 and 0.9 ± 1.3, respectively, and weight-for-length z score was 1.0 ± 1.3 and 0.7 ± 1.4, respectively. Hemoglobin in 0-2, 3-5, 6-8, and 9-11 months old breastfeeding infants was 121.4 ± 15.2 g/L, 117.1 ± 13.0 g/L, 113. 9 ± 11.9 g/L, and 114.4 ± 14.0 g/L, while in 0-2, 3-5, 6-8, and 9-11 months formula feeding infants was 116.3 ± 14.8 g/L, 120.4 ± 11.3 g/L, 119.8 ± 11.2 g/L, and 120.0 ± 11.5 g/L, respectively. Breastfeeding was associated with lower risk of respiratory disease (OR: 0.79; 95% CI: 0.64, 0.99) and diarrhea (OR: 0.75; 95% CI: 0.57, 0.98). Breastfeeding could slightly improve infant physical development, and had a protective effect on the diarrheal and respiratory diseases. Infants aged 3-11 months who were breastfeeding showed lower hemoglobin than that of formula-fed infants and thus should increase intake of iron rich complementary foods.
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Affiliation(s)
| | | | | | | | - Yuna He
- Key Laboratory of Trace Element Nutrition of National Health and Family Planning Commission, National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, No. 29 Nanwei Road, Xicheng District, Beijing 100050, China; (Y.F.); (Y.L.); (Z.Y.); (Y.D.)
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Nie J, Zhang L, Song S, Hartnett AJ, Liu Z, Wang N, Nie W, Yang J, Li Y, Shi Y. Exclusive breastfeeding in rural Western China: does father's co-residence matter? BMC Public Health 2021; 21:1981. [PMID: 34727919 PMCID: PMC8561978 DOI: 10.1186/s12889-021-12025-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Accepted: 10/14/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND China suffers from a low exclusive breastfeeding rate. Though it has been proofed that paternal support benefits breastfeeding a lot, the correlation between father's co-residence and exclusive breastfeeding in China remain undiscovered. This study is to provide population-based evidence for the association of paternal co-residence on exclusive breastfeeding in rural western China. We also attempt to detect how the process works by examining the correlation between the father's co-residence and breastfeeding family support as well as maternal decision-making power. METHODS A cross-sectional study was conducted in 13 nationally-designated poverty-stricken counties in the Qinba Mountains area in 2019. Data on breastfeeding practices, the status of fathers co-residence, breastfeeding family support, and maternal decision-making power were collected via structured questionnaires from 452 caregivers-infant pairs. Multivariate regressions were conducted to explore the correlation between paternal co-residence and exclusive breastfeeding. RESULTS The exclusive breastfeeding (0-6 months) rate was 16% in rural western China. Fathers' co-residence was associated with a lower exclusive breastfeeding rate (OR = 0.413, 95% CI = 0.227-0.750, P = 0.004) and the rate did not improve when the father was the secondary caregiver. Even ruling out support from grandmothers, the association was still negative. Paternal co-residence did not improve maternal perceived breastfeeding family support, neither practically nor emotionally (β =0.109, P = 0.105; β =0.011,P = 0.791, respectively) and it reduced maternal decision-making power (β = - 0.196, P = 0.007). CONCLUSIONS Fathers' co-residence is negatively associated with the exclusive breastfeeding rates in rural western China. More skill-based practical and emotional strategies should be considered on father's education to help them better involvement and show more respect to mothers' decisions.
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Affiliation(s)
- Jingchun Nie
- Center for Experimental Economics in Education, Shaanxi Normal University, No. 620 West Chang'an Street, Chang'an District, Xian, Shaanxi Province, China
| | - Lifang Zhang
- Business School, Beijing Normal University, Beijing, China
| | - Shuyi Song
- Center for Experimental Economics in Education, Shaanxi Normal University, No. 620 West Chang'an Street, Chang'an District, Xian, Shaanxi Province, China
| | - Andrew John Hartnett
- Elliott School of International Affairs, George Washington University, Washington, D.C., USA
| | - Zhuo Liu
- Center for Experimental Economics in Education, Shaanxi Normal University, No. 620 West Chang'an Street, Chang'an District, Xian, Shaanxi Province, China
| | - Nan Wang
- Center for Experimental Economics in Education, Shaanxi Normal University, No. 620 West Chang'an Street, Chang'an District, Xian, Shaanxi Province, China
| | - Weiqi Nie
- Center for Experimental Economics in Education, Shaanxi Normal University, No. 620 West Chang'an Street, Chang'an District, Xian, Shaanxi Province, China
| | - Jie Yang
- Center for Experimental Economics in Education, Shaanxi Normal University, No. 620 West Chang'an Street, Chang'an District, Xian, Shaanxi Province, China.
| | - Ying Li
- Center for Experimental Economics in Education, Shaanxi Normal University, No. 620 West Chang'an Street, Chang'an District, Xian, Shaanxi Province, China
| | - Yaojiang Shi
- Center for Experimental Economics in Education, Shaanxi Normal University, No. 620 West Chang'an Street, Chang'an District, Xian, Shaanxi Province, China
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Liu J, Huo J, Sun J, Huang J, Gong W, Wang O. Prevalence of Complementary Feeding Indicators and Associated Factors Among 6- to 23-Month Breastfed Infants and Young Children in Poor Rural Areas of China. Front Public Health 2021; 9:691894. [PMID: 34660508 PMCID: PMC8517442 DOI: 10.3389/fpubh.2021.691894] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Accepted: 08/25/2021] [Indexed: 11/25/2022] Open
Abstract
This study aimed to estimate the status of complementary feeding (CF) and its associated factors among 6-23-month breastfed infants and young children (IYC). We used secondary data from the China Nutrition Improvement Project on Children in Poor Areas in 2018. The status of CF was provided by parents of IYC through 24-h dietary recall. The study included 13,972 6-23-month-old breastfed IYC comprising 24.7% 6-8-month, 28.5% 9-11-month, 31.4% 12-17-month, and 18-23-month IYC. The highest percentage of IYC introduced to cereal foods was 84.8%. Nearly, 83.6% of 6-8-month infants were introduced to solid or semi-solid food. The prevalence of meeting requirements of non-dairy animal source food and minimum acceptable diet (MAD) was 75.3 and 35.1% of 6-23-month IYC, respectively, and was significantly higher in older than younger IYC (p < 0.001). Age of IYC, education level of parents, paternal employment, and nutrition knowledge of parents were positively associated factors for the prevalence of meeting requirements of MAD, and diarrhea at 2 weeks and maternal employment were negatively associated with MAD. Totally, the prevalence of meeting the requirements of MAD was relatively lower in breastfed IYC. The government should scale up appropriate CF with consideration of food availability.
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Affiliation(s)
| | - Junsheng Huo
- Chinese Center for Disease Control and Prevention, National Institute for Nutrition and Health, Beijing, China
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Factors associated with exclusive breastfeeding practice among mothers in nine community health centres in Nanning city, China: a cross-sectional study. Int Breastfeed J 2021; 16:71. [PMID: 34556129 PMCID: PMC8461910 DOI: 10.1186/s13006-021-00416-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Accepted: 09/07/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The prevalence of exclusive breastfeeding (EBF) is suboptimal in China. There is limited evidence of effective interventions to increase EBF in China. Therefore, it is urgent to explore the potential factors that may be effective in promoting exclusive breastfeeding. Previous studies have mainly focused on socio-demographic factors and the Han ethnic group. This study explores more modifiable influencing factors of EBF in the Guangxi Zhuang Autonomous Region of China. METHODS The cross-sectional data used in this study were collected to provide baseline information on EBF prevalence for a breastfeeding promotion project. A total of 494 mothers of infants aged 0-5 months were recruited from nine community health centres in Nanning, China, in October 2019. Data were collected through face-to-face interviews using structured questionnaires. Infant feeding was measured by 24-h recall. The Chinese version of the Breastfeeding Self-Efficacy Scale-Short Form was used to examine the maternal breastfeeding self-efficacy. Univariate and multivariate logistic regressions were used to examine the factors associated with EBF practices. RESULTS In the present study, the prevalence of exclusive breastfeeding was 37.0%. Higher breastfeeding self-efficacy scores (adjusted odds ratio [AOR] 1.93; 95% confidence interval [CI] 1.25, 2.98), a college degree or above (AOR 2.15; 95% CI 1.24, 3.71), and early initiation of breastfeeding (AOR 2.06; 95% CI 1.29, 3.29) were positively associated with EBF practice. However, the preparation for infant formula before childbirth (AOR 0.30; 95% CI 0.17, 0.52) and premature birth (AOR 0.30; 95% CI 0.10, 0.87) were negatively associated with EBF practice. CONCLUSIONS Exclusive breastfeeding practice was suboptimal and associated with various factors in the study area. The prevalence of EBF was positively associated with higher breastfeeding self-efficacy, education level of mothers, and early initiation of breastfeeding, whereas premature birth and preparation for infant formula before childbirth were barriers to exclusive breastfeeding. Future intervention projects should target mothers with premature babies, lower levels of education, and breastfeeding self-efficacy. Breastfeeding-friendly practices, such as the early initiation of breastfeeding and regulations on breastmilk substitutes, should also be encouraged.
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Yin C, Su X, Liang Q, Ngai FW. Effect of Baby-Led Self-Attachment Breastfeeding Technique in the Postpartum Period on Breastfeeding Rates: A Randomized Study. Breastfeed Med 2021; 16:734-740. [PMID: 33913745 DOI: 10.1089/bfm.2020.0395] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Objective: To evaluate the effects of a baby-led self-attachment breastfeeding support intervention on the prevalence and duration of exclusive breastfeeding and nipple pain at 3 days, 6 weeks, 3 months, and 6 months postpartum among Chinese mothers. Materials and Methods: A randomized study was conducted with 504 mother-infant dyads allocated to the baby-led self-attachment breastfeeding support intervention (n = 251) and standard postpartum care (n = 253). Data on the prevalence and duration of exclusive breastfeeding and nipple pain were collected at 3 days, 6 weeks, 3 months and 6 months postpartum. Results: Mothers in the intervention group were significantly more likely exclusively breastfeeding at 3 days (mean difference = 12.1%, 95% confidence interval [CI]: 3.9-20.2%, p = 0.004) and 6 months postpartum (mean difference = 17.8%, 95% CI: 8.3-27.4%, p < 0.001). They were less likely to stop breastfeeding over the 6-month period, compared with the control group (Hazard ratio = 0.65; 95% CI: 0.49-0.87). They were also less likely to experience nipple pain at 3 days (mean difference = -8.1%, 95% CI: -15.9 to -0.4%, p = 0.04) and 3 months postpartum (mean difference = -4.9%, 95% CI: -8.7 to -1.2%, p = 0.01). Conclusions: The baby-led self-attachment breastfeeding support is clinically effective in increasing the prevalence and duration of exclusive breastfeeding and reducing nipple pain among Chinese mothers.
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Affiliation(s)
- Caixin Yin
- Nursing Department, Guangzhou Women and Children Medical Center, Guangzhou, China
| | - Xi Su
- School of Nursing, Guangzhou Medical University, Guangzhou, China
| | - Qiuxia Liang
- Delivery Department, Guangzhou Women and Children Medical Center, Guangzhou, China
| | - Fei Wan Ngai
- School of Nursing, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong
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Wu W, Zhang J, Silva Zolezzi I, Fries LR, Zhao A. Factors influencing breastfeeding practices in China: A meta-aggregation of qualitative studies. MATERNAL AND CHILD NUTRITION 2021; 17:e13251. [PMID: 34355869 PMCID: PMC8476444 DOI: 10.1111/mcn.13251] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Revised: 06/19/2021] [Accepted: 07/07/2021] [Indexed: 12/03/2022]
Abstract
The World Health Organization recommends that women exclusively breastfeed until their babies are 6 months old and continue to breastfeed while introducing complementary foods. A meta‐aggregation methodology was used to systematically review and synthesise the qualitative studies on factors influencing breastfeeding practices of healthy Chinese women in Greater China. English and Chinese databases were searched to identify peer‐reviewed qualitative studies (published 2008–2019). Relevant data were extracted, and key themes related to factors influencing breastfeeding practices were identified. Of 7587 articles identified, 22 qualitative studies met inclusion criteria for the review, 10 of which were published in Chinese. A total of 87 themes were extracted from all included studies and classified into 9 subcategories: government enactment of policies, implementation of policies in workplaces, social expectations, social support, medical and health services, services with Chinese characteristics, breastfeeding and pumping facilities, maternal perceptions of breastfeeding and self‐efficacy to breastfeed. The nine subcategories were then grouped into four categories. Potential effect associations among these influence factors of breastfeeding practices emerged from categories and subcategories. Family members' influence on breastfeeding motivation and self‐efficacy suggest a potential benefit of breastfeeding promotion interventions targeting the whole family. The role of primary care should be fully exploited in breastfeeding promotion, including both prenatal education and post‐partum visits. Standardising the training and qualifications of maternity matrons (yuesao) and folk breastfeeding specialists (cuirushi) can promote evidence‐based approaches to facilitating breastfeeding during the confinement period. Increased availability of breastfeeding and pumping facilities in the workplace would facilitate continuing breastfeeding after returning to work.
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Affiliation(s)
- Wei Wu
- Vanke School of Public Health, Tsinghua University, Beijing, China.,Department of Nutrition and Food Hygiene, School of Public Health, Peking University, Beijing, China
| | - Jian Zhang
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University, Beijing, China
| | | | | | - Ai Zhao
- Vanke School of Public Health, Tsinghua University, Beijing, China
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Shi H, Li X, Fang H, Zhang J, Wang X. The Effectiveness and Cost-effectiveness of a Parenting Intervention Integrated with Primary Health Care on Early Childhood Development: a Cluster-Randomized Controlled Trial. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2021; 21:661-671. [PMID: 32419119 DOI: 10.1007/s11121-020-01126-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Developing countries require interventions that can sustainably improve early childhood development (ECD) at scale because hundreds of millions of children are at risk of poor development. This study examined the effectiveness and cost-effectiveness of a parenting intervention integrated with primary health care in terms of ECD. A cluster-randomized controlled trial was conducted in 20 urban communities in China, with 82 and 86 children aged 1-2 months enrolled in the intervention and control groups, respectively, and 71 and 69 children, respectively, followed to 14 months of age. All children in both groups received routine primary health care services. Intervention caregivers received a parenting pamphlet and two parenting training sessions during well-child clinic visits; those with children with suspected developmental delay received additional parenting guidance by telephone. Compared with controls, children receiving the intervention had similar developmental outcomes, measured with the Chinese version of the Ages & Stages Questionnaires third edition (ASQ-C), at baseline, but had significantly higher communication (adjusted mean difference = 0.26; 95% CI 0.03, 0.51), fine motor (adjusted mean difference = 0.19; 95% CI 0.01, 0.37), and overall (adjusted mean difference = 0.25; 95% CI 0.10, 0.41) ASQ-C z-scores after 12 months of the intervention. The intervention cost per child was $50.87, and the costs for increasing the communication, fine motor, and overall ASQ-C scores by one SD were $195.65, $267.74, and $203.48, respectively. Our findings indicate that the integration of a parenting intervention with existing primary health care is a cost-effective way to improve ECD.
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Affiliation(s)
- Huifeng Shi
- Department of Maternal and Child Health, School of Public Health, Peking University, Beijing, 38 Xueyuan Road, Haidian District, Beijing, 100191, China
| | - Xuejun Li
- Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, 168 Litang Road, Changping District, Beijing, 102218, China.
| | - Hai Fang
- China Center for Health Development Studies (CCHDS), Peking University, 38 Xueyuan Road, Haidian District, Beijing, 100191, China
| | - Jingxu Zhang
- Department of Maternal and Child Health, School of Public Health, Peking University, Beijing, 38 Xueyuan Road, Haidian District, Beijing, 100191, China
| | - Xiaoli Wang
- Department of Maternal and Child Health, School of Public Health, Peking University, Beijing, 38 Xueyuan Road, Haidian District, Beijing, 100191, China.
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Minimum acceptable diet among children aged 6-23 months in South Kivu, Democratic Republic of Congo: a community-based cross-sectional study. BMC Pediatr 2021; 21:239. [PMID: 34011304 PMCID: PMC8132412 DOI: 10.1186/s12887-021-02713-0] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Accepted: 05/05/2021] [Indexed: 11/10/2022] Open
Abstract
Background Suboptimal child nutrition remains the main factor underlying child undernutrition in Democratic Republic of Congo (DRC). This study aimed to assess the prevalence of minimum acceptable diet and associated factors among children aged 6–23 months old. Methods Community-based cross-sectional study including 742 mothers with children aged 6–23 months old was conducted in 2 Health Zones of South Kivu, Eastern DRC. WHO indicators of Infant and Young Child Feeding (IYCF) regarding complementary feeding practices were used. Logistic regression analysis was used to quantify the association between sociodemographic indicators and adequate minimum acceptable diet for both univariate and multivariate analysis. Results Overall, 33% of infants had minimum acceptable diet. After controlling for a wide range of covariates, residence urban area (AOR 2.39; 95% CI 1.43, 3.85), attendance postnatal care (AOR 1.68; 95% CI 1.12, 2.97), education status of mother (AOR 1.83; 95% CI 1.20, 2.77) and household socioeconomic status (AOR 1.72; 95% CI 1.14, 2.59) were factors positively associated with minimum acceptable diet. Conclusion Actions targeting these factors are expected to improve infant feeding practices in South Kivu. Supplementary Information The online version contains supplementary material available at 10.1186/s12887-021-02713-0.
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Shi H, Yang Y, Yin X, Li J, Fang J, Wang X. Determinants of exclusive breastfeeding for the first six months in China: a cross-sectional study. Int Breastfeed J 2021; 16:40. [PMID: 34001155 PMCID: PMC8130252 DOI: 10.1186/s13006-021-00388-y] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2020] [Accepted: 05/06/2021] [Indexed: 11/26/2022] Open
Abstract
Background Breast milk is the best source of essential nutrients and bioactive components for infants under 6 months. However, little is known about what affects breastfeeding intentions and practices of Chinese mothers. With measures of individual, setting, and sociocultural factors, this study examined determinants of exclusive breastfeeding in the first 6 months of infancy in China. Methods Data were obtained from a national cross-sectional survey in China in 2018 that included 5237 infants under 6 months with available measurements of breastfeeding. A 24-h reported food recall method was applied to assess breastfeeding and complementary food intake in the past 24 h. Potential breastfeeding determinants categorized into six aspects were measured: (1) infant health, (2) maternal sociodemographic characteristics, (3) maternal health, (4) breastfeeding support from family, friends, and workplace, (5) social support for breastfeeding, and (6) maternal breastfeeding experiences and knowledge. Reasons for non-commencement or early cessation of breastfeeding were evaluated for non-breastfed infants. For breastfed infants, multivariate logistic regression was used to explore the determinants of exclusive breastfeeding. Results About 30 % (29.5%) of infants under 6 months were exclusively breastfed; 2.3% (2.3%) had never been breastfed and 3.2% had ceased breastfeeding. No breast milk (60.7%), maternal illness (13.9%), and infant illness (13.1%) were the top three reasons for non-commencement of breastfeeding. Insufficient breast milk was the reason given for ceasing breastfeeding early by almost two thirds of caregivers who had stopped breastfeeding. The following factors were associated with exclusive breastfeeding: maternal higher education, formal employment with ≥6 months of paid maternity leave, support of the husband and best friends for breastfeeding, a breastfeeding-supportive society, and better breastfeeding knowledge and experiences (a previous successful breastfeeding experience ≥6 months and early initiation of breastfeeding). Maternal age of ≥40 years, caesarean delivery, and infant disease history were associated with non-exclusive breastfeeding. Conclusions The exclusive breastfeeding rate is still very low in China. Multidimensional barriers contribute to this situation. A comprehensive intervention framework is needed to increase optimal breastfeeding and achieve substantial public health gains.
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Affiliation(s)
- Huifeng Shi
- Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China.,Department of Maternal and Child Health, Peking University School of Public Health, Beijing, China
| | - Yumei Yang
- School of Economics and Management, Beijing Forestry University, Beijing, China
| | - Xiaohan Yin
- Department of Maternal and Child Health, Peking University School of Public Health, Beijing, China
| | - Jia Li
- China Development Research Foundation, Beijing, China
| | - Jin Fang
- China Development Research Foundation, Beijing, China.
| | - Xiaoli Wang
- Department of Maternal and Child Health, Peking University School of Public Health, Beijing, China. .,National Health Commission Key Laboratory of Reproductive Health, Beijing, China.
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Wu Q, Huang Y, Helena van Velthoven M, Wang W, Chang S, Zhang Y. Feasibility of using WeChat to improve infant and young child feeding in rural areas in China: A mixed quantitative and qualitative study. PLoS One 2021; 16:e0246942. [PMID: 33630873 PMCID: PMC7906387 DOI: 10.1371/journal.pone.0246942] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Accepted: 01/29/2021] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Appropriate infant and young child feeding practices are the basis for child nutrition. In China, WeChat is gradually changing the channels through which people receive information. The paper aims to explore the feasibility of using WeChat to improve infant and young child feeding in rural China. METHODS A mixed-methods study was carried out in Huzhu County, Qinghai province, China. We conducted two cross-sectional surveys with children aged 6-23 months and their caregivers in 2012 (N = 1804) and 2018 (N = 754), respectively. Quantitative data were collected on feeding knowledge and practices, caregiver's use of smartphones and WeChat. Qualitative data were from 33 semi-structured interviews with pregnant women and mothers. In addition, we developed a WeChat feeding health education platform and asked women about their experiences with using it. RESULTS In both cross-sectional surveys, less than 10% of caregivers knew that breastfeeding can be continued up to two years, less than 50% knew the accurate duration of exclusive breastfeeding, and only around 20% knew meat can be given to children from the age of 6-8 months. Similarly, the feeding practices were suboptimal and most key infant feeding practices did not change over the years. Only around 30% of caregivers ever received feeding information during pregnancy or after delivery in both surveys. Around 50% of caregivers received information from their relatives and friends, followed by 30% from health facilities and communities. More than 80% of mothers were currently using both a smartphone and the WeChat app, and 75.4% of them were willing to receive feeding information from WeChat official accounts. The WeChat feeding health education platform developed by our study team was generally well accepted by women. CONCLUSIONS There was an absence of accurate information sources on infant feeding and child nutrition. WeChat could be a potential way to deliver infant feeding recommendations to pregnant women and mothers in rural China. TRIAL REGISTRATION ChiCTR-PRC-11001446 (The controlled intervention trial for complementary food supplements "Yingyangbao"); ChiCTR1800017364 (the randomized controlled trial for WeChat).
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Affiliation(s)
- Qiong Wu
- Department of Integrated Early Childhood Development, Capital Institute of Pediatrics, Beijing, China
| | - Yiwen Huang
- Department of Integrated Early Childhood Development, Capital Institute of Pediatrics, Beijing, China
| | | | - Wei Wang
- Department of Integrated Early Childhood Development, Capital Institute of Pediatrics, Beijing, China
| | - Suying Chang
- Health and Nutrition, Water, Environment and Sanitation Section, UNICEF China, Beijing, China
| | - Yanfeng Zhang
- Department of Integrated Early Childhood Development, Capital Institute of Pediatrics, Beijing, China
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Liu J, Huo J, Liu Z, Sun J, Huang J. Prevalence and Temporal Trend (2016-2018) of Anaemia among 6-23-Month-Old Infants and Young Children in China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18042041. [PMID: 33669777 PMCID: PMC7922411 DOI: 10.3390/ijerph18042041] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 02/12/2021] [Accepted: 02/17/2021] [Indexed: 11/16/2022]
Abstract
Anaemia is a public health problem that can lead to various harmful effects on physical and neurodevelopment in infants and young children (IYC). This study aimed to investigate trends of anaemia and haemoglobin concentration among 6- to 23-month-old Chinese IYC from 2016 to 2018. We used data from the China Nutrition Improvement Project on Children in Poor Areas (CNIPCPA), conducted in 142 national-level poor counties of 20 provinces, autonomous regions, and municipalities from 2016 to 2018. Our study included 103,621 6- to 23-month-old IYC selected by a stratified multistage cluster sampling design. There were 26,303, 33,443, and 43,875 IYC in the survey in 2016, 2017, and 2018, respectively. The overall prevalence of anaemia was 27.0% in the three years. The prevalence of anaemia was 28.0%, 27.2%, and 26.2%, and the mean haemoglobin (Hb) was 11.82, 11.81, and 11.88 g/dL in 2016, 2017, and 2018, respectively. The prevalence of anaemia was highest in 6- to 11-month-olds, and declined with age. There was a gap in the education level between parents. However, the percentage of education improved in the rural areas of China. The prevalence of anaemia decreased significantly in the three years, which shows that prevention and control actions achieved the initial results.
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Affiliation(s)
- Jing Liu
- National Institute for Nutrition and Health, Chinese Center for Disease Control Prevention, No. 27 Nanwei Road, Xicheng District, Beijing 100050, China; (J.L.); (J.S.); (J.H.)
| | - Junsheng Huo
- National Institute for Nutrition and Health, Chinese Center for Disease Control Prevention, No. 27 Nanwei Road, Xicheng District, Beijing 100050, China; (J.L.); (J.S.); (J.H.)
- Correspondence: ; Tel.: +86-135-0115-2782
| | - Zengyan Liu
- Fengtai District Center for Disease Control and Prevention, No.0 Kanyang Road, Beijing 100070, China;
| | - Jing Sun
- National Institute for Nutrition and Health, Chinese Center for Disease Control Prevention, No. 27 Nanwei Road, Xicheng District, Beijing 100050, China; (J.L.); (J.S.); (J.H.)
| | - Jian Huang
- National Institute for Nutrition and Health, Chinese Center for Disease Control Prevention, No. 27 Nanwei Road, Xicheng District, Beijing 100050, China; (J.L.); (J.S.); (J.H.)
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Kang L, Liang J, He C, Miao L, Li X, Dai L, Li Q, Liu Z, Zhu J, Wang Y, Liu H. Breastfeeding practice in China from 2013 to 2018: a study from a national dynamic follow-up surveillance. BMC Public Health 2021; 21:329. [PMID: 33568130 PMCID: PMC7874457 DOI: 10.1186/s12889-021-10211-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Accepted: 01/10/2021] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Breastfeeding is important for the physical and psychological health of the mother and child. Basic data on breastfeeding practice in China are out-of-date and vary widely. This study aimed to evaluate the progress of breastfeeding practice in China, as well as to explore the bottlenecks in driving better practice. METHODS This was an observational study. We used data from the Under-5 Child Nutrition and Health Surveillance System in China for the period 2013-2018. The prevalence of early initiation of breastfeeding (EIBF) and exclusive breastfeeding (EBF) were calculated for each year for subgroups of China. The Cochran-Armitage test was used to explore the time trends. The annual percent of change (APC) were calculated by log-linear regression followed by exp transformation. RESULTS The prevalence of EIBF increased significantly from 44.57% (95% CI: 44.07, 45.07) in 2013 to 55.84% (95% CI: 55.29, 56.38) in 2018 (Ptrend < 0.001), with an APC of 4.67% (95% CI: 3.51, 5.85). And the prevalence of EBF increased rapidly from 16.14% (95% CI: 15.10, 17.18) to 34.90% (95% CI: 33.54, 36.26) (Ptrend < 0.001), with an APC of 14.90% (95% CI: 9.97, 20.04). Increases were observed in both urban and rural areas, with urban areas showing greater APCs for EIBF (6.05%; 95% CI: 4.22, 7.92 v.s. 2.26%; 95% CI: 1.40, 3.12) and EBF (18.21%; 95% CI: 11.53, 25.29 v.s. 9.43%; 95% CI: 5.52, 13.49). The highest EBF prevalence was observed in the East, but the Central area showed the highest APC. The prevalence of EBF decreased with increasing age within the first 6 months, especially after 3 months. CONCLUSION The prevalence of both EIBF and EBF in China are improving in recent years. The rural and West China could be the key areas in the future actions. More efforts should be made to protect and promote breastfeeding to achieve near- and long-term goals for child health.
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Affiliation(s)
- Leni Kang
- National Office for Maternal and Child Health Surveillance, West China Second University Hospital, Sichuan University, Chengdu, China
| | - Juan Liang
- National Office for Maternal and Child Health Surveillance, West China Second University Hospital, Sichuan University, Chengdu, China
| | - Chunhua He
- National Office for Maternal and Child Health Surveillance, West China Second University Hospital, Sichuan University, Chengdu, China
| | - Lei Miao
- National Office for Maternal and Child Health Surveillance, West China Second University Hospital, Sichuan University, Chengdu, China
| | - Xiaohong Li
- National Office for Maternal and Child Health Surveillance, West China Second University Hospital, Sichuan University, Chengdu, China
| | - Li Dai
- National Office for Maternal and Child Health Surveillance, West China Second University Hospital, Sichuan University, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children of the Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, China
| | - Qi Li
- National Office for Maternal and Child Health Surveillance, West China Second University Hospital, Sichuan University, Chengdu, China
| | - Zheng Liu
- National Office for Maternal and Child Health Surveillance, West China Second University Hospital, Sichuan University, Chengdu, China
| | - Jun Zhu
- National Office for Maternal and Child Health Surveillance, West China Second University Hospital, Sichuan University, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children of the Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, China
| | - Yanping Wang
- National Office for Maternal and Child Health Surveillance, West China Second University Hospital, Sichuan University, Chengdu, China
| | - Hanmin Liu
- Key Laboratory of Birth Defects and Related Diseases of Women and Children of the Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, China.
- Department of Pediatrics, West China Second University Hospital, Sichuan University, No. 17, Section 3, South Renmin Road, Chengdu, 610041, China.
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Yu G, Liu F, Zhao Y, Kong Y, Wei H. Promoting Breastfeeding and Lactation Among Mothers of Premature Newborns in a Hospital in China. Nurs Womens Health 2021; 25:21-29. [PMID: 33450242 DOI: 10.1016/j.nwh.2020.11.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Revised: 09/24/2020] [Accepted: 11/01/2020] [Indexed: 02/06/2023]
Abstract
OBJECTIVE To promote breastfeeding and lactation in mothers separated from their premature infants admitted to the NICU in a hospital in China. DESIGN For this evidence-based practice project we used a mixed method of survey measures and interviews and were guided by the Joanna Briggs Institute Practical Application of Clinical Evidence System and Getting Research Into Practice framework. SETTING/LOCAL PROBLEM Obstetric unit of a Women and Children's Hospital in China from September 2017 to August 2018. Before the project, the partial breastfeeding rate in the hospital was 17.9%, and the exclusive breastfeeding rate of premature infants was 1.8%; these rates were much lower than the national breastfeeding rate in the country. PARTICIPANTS Seventeen nurses and 70 mothers of premature infants. INTERVENTION/MEASUREMENTS The project included three phases: (a) finding the best evidence to promote breastfeeding in the literature and identifying the gaps between best practice and current practice, (b) implementing best practice strategies, and (c) comparing pre- and postintervention outcomes. Based on the evidence in the literature and the barriers, strategies were implemented in practice to promote breastfeeding and lactation among women separated from their preterm newborns. Chi-square and t tests were performed to compare the pre-/postintervention differences. RESULTS Partial breastfeeding rates increased from 17.9% to 52.7%, and exclusive breastfeeding rates increased from 1.8% to 4.1%. Compliance with breastfeeding guidelines and measures of maternal lactation volume both improved significantly. CONCLUSION Promoting breastfeeding and lactation among mothers of premature infants requires not only scientific knowledge but also a caring environment and family-centered practice.
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Wu Q, Huang Y, Liao Z, van Velthoven MH, Wang W, Zhang Y. Effectiveness of WeChat for Improving Exclusive Breastfeeding in Huzhu County China: Randomized Controlled Trial. J Med Internet Res 2020; 22:e23273. [PMID: 33270026 PMCID: PMC7746496 DOI: 10.2196/23273] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Revised: 09/06/2020] [Accepted: 11/02/2020] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND The benefits of breastfeeding for both infants and mothers have been well recognized. However, the exclusive breastfeeding rate in China is low and decreasing. Mobile technologies have rapidly developed; communication apps such as WeChat (one of the largest social networking platforms in China) are widely used and have the potential to conveniently improve health behaviors. OBJECTIVE This study aimed to assess the effectiveness of using WeChat to improve breastfeeding practices. METHODS This 2-arm randomized controlled trial was conducted among pregnant women from May 2019 to April 2020 in Huzhu County, Qinghai Province, China. Pregnant women were eligible to participate if they were aged 18 years or older, were 11 to 37 weeks pregnant with a singleton fetus, had no known illness that could limit breastfeeding after childbirth, used WeChat through their smartphone, and had access to the internet. A total of 344 pregnant women were recruited at baseline, with 170 in the intervention group and 174 in the control group. Women in the intervention group received breastfeeding knowledge and promotion information weekly through a WeChat official account from their third month of pregnancy to 6 months postpartum. The primary outcome of exclusive and predominant breastfeeding rate was measured 0-1 month, 2-3 months, and 4-5 months postpartum. RESULTS At 0-1 month postpartum, the exclusive breastfeeding rate was significantly higher in the intervention group than that in the control group (81.1% vs 63.3%; odds ratio [OR] 2.75, 95% CI 1.58-4.78; P<.001). Similarly, mothers in the intervention group were more likely to provide predominantly breast milk (OR 2.77, 95% CI 1.55-4.96; P<.001) and less likely to give dairy products to their children (OR 0.40, 95% CI 0.21-0.75; P=.005). There was no statistically significant difference for exclusive breastfeeding rate 2-3 months (P=.09) and 4-5 months postpartum (P=.27), though more children in the intervention group were exclusively breastfed than those in the control group 2-3 months postpartum (intervention: 111/152, 73.0%; control: 96/152, 63.2%) and 4-5 months postpartum(intervention: 50/108, 46.3%; control: 46/109, 42.2%). CONCLUSIONS This study is the first effort to promote exclusive breastfeeding through WeChat in China, which proved to be an effective method of promoting exclusive breastfeeding in early life. WeChat health education can be used in addition to local breastfeeding promotion programs. TRIAL REGISTRATION Chinese Clinical Trial Registry ChiCTR1800017364; http://www.chictr.org.cn/showproj.aspx?proj=29325. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.1186/s12889-019-7676-2.
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Affiliation(s)
- Qiong Wu
- Capital Institute of Pediatrics, Beijing, China
| | - Yiwen Huang
- Capital Institute of Pediatrics, Beijing, China
| | - Zijun Liao
- Capital Institute of Pediatrics, Beijing, China
| | | | - Wei Wang
- Capital Institute of Pediatrics, Beijing, China
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