Breastfeeding Laws and Breastfeeding Practices by Race and Ethnicity

ObjectivesWe sought to examine breastfeeding practices by race and ethnicity in areas with and without eight specific breastfeeding laws.MethodsThe 2003 through 2010 National Health and Nutrition Examination Survey provides national breastfeeding practice information. We assessed eight breastfeeding laws before and after legislation was enacted and linked to population-based estimates of breastfeeding initiation and duration for children between birth and age one.FindingsRelative to Whites, Mexican-American infants were 30% more likely to breastfeed for at least 6 months in areas with laws protecting break-time from work to pump, and 20% more likely to breastfeed for at least 6 months in areas with pumping law enforcement provisions. Unexpectedly, five laws with the intention of supporting breastfeeding duration were significantly less helpful for African-American women relative to White women. African-American women were nearly half as likely to breastfeed for at least 6 months, relative to Whites in areas with provisions to provide break-time from work (adjusted odds ratio [AOR], 0.6; 95% confidence interval [CI], 0.5–0.8), private areas to pump at work (AOR, 0.6; 95% CI, 0.4–0.8), exemption from jury duty (AOR, 0.6; 95% CI, 0.4–0.9), awareness education campaigns (AOR, 0.5; 95% CI, 0.3–0.8), and pumping law enforcement provisions (AOR, 0.6; 95% CI, 0.5–0.8).ConclusionsBreastfeeding laws influence African Americans and Mexican Americans differently than Whites. Examination of specific laws in conjunction with the interaction of known specific barriers for African-American mothers could help to achieve the Healthy People 2020 goals for breastfeeding.     

Community Breastfeeding Attitudes and Beliefs

The cultural norms of a society have a powerful influence over health behavior decisions such as choosing an infant feeding method. The objective of this study was to explore the community breastfeeding perspective by examining breastfeeding attitudes and beliefs, experiences, and behaviors of a U.S. university community through an online survey. Linear and logistic regressions were used to determine predictors of those who had breastfed and those with positive breastfeeding attitudes and beliefs. Through the findings, the researchers suggest that exposure to breastfeeding and increasing positive breastfeeding attitudes and beliefs are important as the focus for public breastfeeding campaigns.     

Traditionality and Cancer Screening Practices Among American Indian Women in Vermont

The study purpose was to examine the relationship between cancer screening and traditionality, using a culturally specific survey instrument. American Indian (AI) women were randomly selected from the Vermont Breast Cancer Surveillance System (VBCSS), a statewide mammography database. The 13 items that assessed traditionality examined identity, cultural beliefs, customs, and health practices. The sample of 115 was predominately married, educated, middle class, insured, and rural. Significant associations were found between traditionality and past mammography and clinical breast examination (CBE) behavior, as well as future mammography intention. Results suggest that traditionality scales can be useful for identifying differences in screening behavior, with further testing of traditionality items with other AI women recommended. International implications of the study findings are also addressed.     

Previous Breastfeeding Practices and Duration of Exclusive Breastfeeding in the United States

We examined the influence of duration of exclusive breastfeeding (DEBF) for a mother’s earlier children on the DEBF for her later children among multiparous women from the 2002 National Survey of Family Growth. DEBF was categorized as: never breastfed (NBF) (referent); not exclusively breastfed or exclusively breastfed for <4 months (EBF < 4); and exclusively breastfed for ≥4 months (EBF ≥ 4). We examined DEBF using weighted percentages and odds ratios (OR) with 95% confidence intervals (CI) from multinomial logistic regression models, adjusting for maternal factors. About 70% of multiparous women (n = 2,149) repeated the duration of exclusive breastfeeding of their first child for their second child; 14% of women repeated EBF ≥ 4. Among multiparous women, the adjusted odds ratio for EBF ≥ 4 for second children was 7.2 (95% CI = 4.0–12.9) when first children were EBF < 4 and 90.7 (95% CI = 45.4–181.4) when first children were EBF ≥ 4, relative to NBF first children. In analyses where DEBF of third children was the outcome, odds of EBF ≥ 4 were more strongly influenced by DEBF of second children while the impact of DEBF of first children was not as strong. Older maternal age and being married were related to an increased DEBF. Being married at second birth predicted a change from NBF for first children to EBF ≥ 4 for second children (OR = 6.2, 95% CI = 2.7–14.2). In conclusion, mothers generally repeated the DEBF of their previous child. For third children, DEBF of the second child was more likely to be repeated than that of the first child.     

Breastfeeding Practices among Mothers in Southwest Nigeria

BackgroundThis study was conducted to determine the breastfeeding practices among parous antenatal attendees in two teaching hospitals in Southwest Nigeria.MethodsA cross-sectional study was carried out on 340 parous antenatal clinic attendees in two teaching hospitals in Ogun State, Nigeria. A structured questionnaire was used to obtain data on breastfeeding practices. Data were analyzed using Statistical Package for Social Sciences (SPSS) windows version 21.0 (IBM Corp., Armonk, NY, USA).ResultsOut of a total of 340 women, 319 (93.8%) breastfed their last babies. The median duration of breastfeeding was 15 months. One hundred and thirty two women (38.8%) initiated breastfeeding within 30 minutes of delivery, and 200 women (58.8%) exclusively breastfed their babies for six months. The majority of the women, 299(87.9%k) did not report any problem associated with breastfeeding. Logistic regression analysis showed that women who had no breastfeeding problems were more likely to exclusively breastfeed their infants for six months compared to those with breastfeeding problems (AOR 3.4; CI 1.6–7.1; P=0.001). Similarly, women who got breastfeeding information from mass media were more likely to practice exclusive breastfeeding for six months compared to those that got breastfeeding information from other sources (AOR42.2; CI 3.1–568.5; P=0.005).ConclusionExclusive breastfeeding is suboptimal in Ogun State, Nigeria. Provision of breastfeeding information via mass media will assist in improving breastfeeding practice. Educating mothers on the techniques that help to prevent breastfeeding complications will also be beneficial.     

Secondary School Students' Attitudes and Beliefs about Breastfeeding

The incidence and prevalence of breastfeeding has increased in the United States and Canada in the past decade, but in spite of its known benefits it is often abandoned before infants are two months of age. Society lacks the attitudes and knowledge necessary for breastfeeding success. A survey of the knowledge, beliefs and attitudes of 409 secondary school students in British Columbia, Canada, revealed misconceptions about the nature of breastfeeding. A high percentage felt it was unacceptable in social situations. The findings point to a need for the integration of information about breastfeeding into school health programs, biology, home economics/nutrition and family life/sexuality courses. Increased knowledge and discussion to foster positive attitudes could increase breastfeeding duration among parents in the future.     

The Role of Workplace Characteristics in Breastfeeding Practices

ABSTRACT

The present analyses were undertaken to understand the role of workplace characteristics in the breastfeeding practices of working women. The effects of the perception of the availability of employer-sponsored child care, the perception of the availability of a flexible schedule, hours worked at home, and worked a fixed schedule on breastfeeding outcomes were estimated using a sample of 1,506 births from the National Longitudinal Survey of Youth 1979 and the Children of the National Longitudinal Survey of Youth 1979. The availability of employer-sponsored child care increased the likelihood of breastfeeding six months after birth by 47 percent. In addition, working an additional eight hours at home per week, at the mean, increased the probability of breastfeeding initiation by 8 percent and breastfeeding six months after birth by 16.8 percent. Workplace characteristics show promise as an effective way to increase breastfeeding rates among working women.     

Smoking rates among American Indian women giving birth in Minnesota. A call to action

Maternal smoking is associated with a number of adverse effects including neonatal mortality, preterm delivery, low birth weight, decreased lung growth and function, and increased incidence of lower respiratory infections. This study looked at smoking trends among American Indian and white women in Minnesota who gave birth between 1999 and 2003. The authors used data from birth certificates issued by the state to determine the rate of smoking among both groups of women. They broke down the data further to look at and compare smoking rates of American Indian and white women based on where they gave birth (greater Minnesota or the Twin Cities metro area), when they began receiving prenatal care, their level of education, their age, the number of children they already had, and the weight of their baby. They found that 39% of American Indian women in Minnesota who gave birth during that period reported smoking, compared with 11% of white women. In addition, their findings showed that cigarette use among American Indian women in Minnesota who gave birth in 2003, was 36.5%--double the national rate of 18.3% forAmerican Indian women.     

Attitudes Towards Evidence-Based Practice in Substance Use Treatment Programs Serving American Indian Native Communities

The Journal of Behavioral Health Services & Research - The objective of this paper was to compare attitudes towards evidence-based practice (EBP) of substance use disorder treatment (SUDT)...     

Breastfeeding Practices Among First-Time Mothers and Across Multiple Pregnancies

To investigate maternal characteristics associated with breastfeeding initiation and success. Women enrolled in the Mothers Outcomes After Delivery study reported breastfeeding practices 5?C10?years after a first delivery. Women were classified as successful breastfeeding initiators, unsuccessful initiators, or non-initiators. For the first birth, demographic and obstetrical characteristics were compared across these three breastfeeding groups. For multiparous women, agreement in breastfeeding status between births was evaluated. Multivariate regression analysis was used to identify characteristics associated with non-initiation and unsuccessful breastfeeding across all births. Of 812 participants, 740 (91%) mothers tried to breastfeed their first child and 593 (73%) reported breastfeeding successfully. In a multivariate analysis, less educated women were less likely to initiate breastfeeding (odds ratio (OR) for non-initiation 1.97; 95% confidence interval (CI) 1.23, 3.14). There was a notable decrease in breastfeeding initiation with increasing birth order: compared to the first birth, the odds for non-initiation after a second delivery almost doubled (OR 1.83, 95% CI 1.42, 2.35) and the odds for non-initiation after a third delivery were further increased (OR 2.44, 95% CI 1.56, 3.82). Successful breastfeeding in a first pregnancy was a predictor of subsequent breastfeeding initiation and success. Specifically, women who did not attempt breastfeeding or who reported unsuccessful attempts to breastfeed at first birth were unlikely to initiate breastfeeding at later births. Cesarean delivery was not associated with breastfeeding initiation (OR 1.01; 95% CI 0.68, 1.48) or success (OR 1.33; 95% CI 0.92, 1.94). Breastfeeding practices after a first birth are a significant predictor of breastfeeding in subsequent births.     

Breastfeeding Practices and Associated Factors in Shanghai: A Cross-Sectional Study

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.     

Attitudes toward Breastfeeding in Perth,Australia: Qualitative Analysis

Breastfeeding is promoted as the preferred method of feeding for infants up to at least the age of 4 to 6 months. While the majority of Australian mothers initiate breastfeeding, approximately half have terminated breastfeeding before 6 months postpartum. A series of focus groups were conducted to identify societal attitudes to breastfeeding that may have a negative impact on breastfeeding duration. Analysis of the dominant themes to emerge from the focus group interviews indicate that (1) there is general agreement that breastfeeding in public is socially acceptable, provided the woman does so discreetly; (2) appropriate facilities should be provided in places frequented by young families where mothers can breastfeed in private, should they choose to do so; (3) fathers should be included in all pre- and perinatal breast-feeding classes and the content of the classes should be expanded to incorporate the importance of the supporting role of the partner; (4) breastfeeding classes should address the issue of breastmilk insufficiency (real and perceived) to allay the common concerns of mothers; and (5) teenage girls and boys should be the target of school-based breastfeeding education programs that address the psychological and sexual aspects of breastfeeding, in addition to the nutritive and health benefits.     

病人权利,义务在医疗实践中的保证

论述了病人权利和医疗法律法规中的地位,归纳了病人权利,义务的基本内容。在此基础提出了病人权利,义务在医疗实践中保证的措施,指出：医疗管理人员工作者要学习法律法规,医疗机构要建立必要可行的制度,使病人充分享有权利,履行应尽义务;医务人员要给予就医者足够的医疗信息,使其具有选择医疗方式的权利;在医疗实践中还应尽量满足就医者的特需请求。