Breast feeding pattern in urban infants in Chandigarh

The pattern of breast feeding and the factors which determine the practice was assessed in 670 mothers from urban areas of Chandigarh. Unsupplemented breast milk was administered to only 36.6 percent babies until 4 months of age. Women from lower socio economic class, uneducated and poorly educated mothers were more successful than those from the upper socio economic class or with higher education (P=<0.01). The success rate of breast feeding was higher amongst babies born at home (50.0%) as compared to those born in the hospital (32.3%). Similarly, higher proportion of male infants were successfully breast fed (40.3%) as compared to females (31.6%). Amongst the weaned infants in more than 60 percent, breast feeding was discontinued before 1 month of age. The main reason for failure of successful breast feeding was insufficient milk. Promotional efforts for unsupplemented breast feeding should consider some of the above factors for their success.     

Breast feeding duration in consecutive offspring: a prospective study from southern Brazil

The association between breast feeding duration in two consecutive pregnancies was studied in a prospective study in southern Brazil. In a population-based sample of 5960 women giving birth in 1982, 1386 delivered a second child within 4 years. The data were analyzed using life table techniques. The duration of breast feeding of the second child increased directly according to the duration the previous child had been breast fed. In particular, when the previous child had been breast fed for 6 months or more, the subsequent child was clearly more likely to be breast fed. However, when the previous child had been breast fed for under 6 months, the differences among subsequent children disappeared after 3-6 months. These differences were still present after stratification by family income, maternal education and parity. Mothers with a previous unsuccessful or problematic breast feeding experience should receive special priority in promotion campaigns.     

Breast feeding: physical growth during infancy

Five hundred and seventyfour infants between 1 and 12 months of age who were exclusively breast fed after normal hospital birth, were studied for physical growth in weight, length and head circumference. The study group infants registered lower mean weight and length throughout the first year, but marked faltering in growth was observed in weight at 4 months and in length at 7 months of age. Comparison with growth of high income group infants from Delhi shows that the study infants lagged behind in weight at 3 months and in length at 6 months of age. These findings suggest inadequacy of mother’s milk beyond 4 months of age. Hence for prevention of malnutrition, introduction of weaning foods should be encouraged by 4 to 6 months of infant’s life.     

Breast feeding practices in a resettlement colony and it’s implications for promotional activities

The mothers of 547 children less than three years of age were interviewed for breastfeeding practices using WHO suggested methodology in a resettlement colony of South Delhi. Only 1.8% of children were never breastfed. Prelacteal feeds were given in 90.9% of infants. More than half received their first breastfeed on 3rd day or later. Among children under three months of age, one third were already receiving top milk. 68.4% of mothers felt that the child should be breastfed for as long as possible. Demand feeding was practised by 95% of the mothers. Most of the mothers did not seek privacy to breastfeed their children. The need to identify desirable and. undesirable infant feeding practices prevalent in an area has been stressed so that appropriate promotional activities can be carried out more effectively.     

Factors influencing prevalence of breastfeeding in a resettlement colony of New Delhi

Influence of some family and maternal characteristics on prevalence of breastfeeding was studied in a cross sectional study using WHO suggested methodology. 547 mothers with children less than three years of age were interviewed with the help of a schedule. Age and parity of the mother, sex of the child, length of urban stay, mother’s going for work did not influence the prevalence of breastfeeding. Prevalence was higher among illiterate mothers and mothers belonging to lower socio-economic status. The mothers from higher socio-economic status initiated breastfeeding earlier. More mothers from higher socio-economic status and those with better education thought that supplementation was needed before the child was 4 months old and felt that breastfeeding was needed for less than two years.     

会宁地区437名婴幼儿喂养方式调查

目的：该研究通过调查经济不发达的会宁地区婴幼儿早期喂养方式,明确相关影响因素,以便为有针对性干预提供基础资料。方法：参考地域、经济因素,采用分层整群抽样法以会宁地区7个乡镇的437名婴幼儿为调查对象,通过抚养人利用统一调查表记录儿童出生24个月内母乳喂养及辅食添加情况,同时用膳食频率法收集调查对象上一年的营养素补充剂的摄入情况。结果：调查对象出生6个月内基本纯母乳喂养率、混合喂养率、人工喂养率分别为45.3%,40.5%和14.2%。最为突出的问题是辅食添加不合理,主要表现为添加不及时。配方奶粉添加最早,平均添加时间为6.4个月,畜禽肉类添加最迟,平均添加时间为17.2个月。谷类、蔬菜水果类和蛋类添加较多,而鱼虾等水产品添加较少。营养素补充剂应用尚不普遍,在选用营养素补充剂时,城镇抚养人主要是根据医生的建议,农村抚养人主要根据家人的经验,且受电视、广告等媒体的影响较大。结论：会宁地区婴幼儿早期喂养方式存在较多不合理之处。应通过营养教育,提高婴幼儿抚养人的营养知识水平,以改善不合理的喂养方式。［中国当代儿科杂志,2009,11（6）：460-463］     

Supplementary feeding in the maternity ward shortens the duration of breast feeding

In a prospective study, feeding routines of a maternity unit and the subsequent feeding patterns of 521 newborns were analysed. During the stay in the maternity unit, 69% of newborns were exclusively breast fed and 1% received only donor's milk from the milk bank and/or formula. Nine percent received their mothers' milk by bottle at least once and 21% received one or more supplementary feedings with donor's milk from the milk bank. One-quarter of the children received supplementary feeds on the third day of life, the indications for this being birth weight less than 3.0 kg, maternal diabetes or gestational diabetes, “insufficient amounts” of milk or fussiness. At three months, 65% were being exclusively breast fed and 15% partially breast fed. In a multiple logistic regression analysis, the potential determinants (neonatal feeding, maternal characteristics, characteristics of the delivery and the child) for the duration of breast feeding were included. The adjusted relative risk (estimated as odds ratios, OR) of not being breast fed at three months was associated with maternal age (< 25 years, OR 4.2), maternal smoking (OR 4.0), neonatal feeding (supplements given, OR 3.9) and initial weight loss (10% or more, OR 2.8). Thus the administration of supplementary donor's milk or formula during the early neonatal period was associated with an increased risk of a short duration for breast feeding, even after adjustment for a number of potential confounders.     

Breast feeding and the dietary habits of children in rural Somalia

Breast feeding and dietary habits were studied prospectively in a cohort of children under the age of five years in a rural Somali community. The median duration of breast feeding was 19.5 months. However, all the children also received cow's milk by cup from the first day of life and onwards. Energy supplements (mainly sugar and oil) as well as additional water were given daily from early infancy. Staples, protein-rich foods (beans and meat), vegetables and fruits were usually introduced when the children reached the age of 12-18 months. There was a seasonal variation with the lowest intake of protein-rich and vitamin-rich foods during the rains in May to June. Thus, there was a complete absence of exclusive breast feeding. Energy-reinforced cow's milk and human milk dominated the diet up to the age of one year. Staples were mixed with oil and supplemented with milk, thereby leading to a much higher energy density in the complementary food than is usually the case in African communities.     

Knowledge and attitude among child development project officers towards breast feeding

A study was conducted to determine the knowledge and attitude about breast feeding (BF) amongst child development project officers (CDPOs) working in Integrated Child Development Services Scheme. A semi structured pretested questionnaire was administered. It was found that majority of respondent had correct knowledge about feeding of colostrum, age of initiation of breast feeding and introduction of semi-solid foods. Majority of CDPOs had the knowledge that consumption of dry fruits, milk and desi ghee would increase that breast milk secretion. The percentage of subjects who were aware that BF should be discontinued if mother is suffering from illness like breast cancer (48%) tuberculosis (57%), malaria (67%) and Diarrhoea (84%). There is need of continuing education of CDPOs for updating their knowledge.     

Enteral feeding of low birth weight infants

There is sufficient evidence at present to support early enterai feeding of low birth weight (LBW) neonates, including those who are sick or very preterm (< 30 weeks). Trophic feeding with human milk initiated within 48 hours of birth at 10–15 ml/kg/day improves later tolerance to graded increment of enterai feeding volumes without increased risk of necrotizing enterocolitis. Trophic feeding supports increments of feeding volumes by 30 ml/kg/day by intermittent gavage feeding. Non-nutritive sucking and spoon-feeding aid earlier transition to exclusive breast-feeding. Human milk promotes adequate growth of most preterm neonates, though many need multivitamin and mineral supplementation. The role of human milk fortifiers to promote growth appears controversial.     

Breast feeding practices and severe hyperbilirubinaemia

This study establishes the association between early onset severe hyperbilirubinaemia (serum bilirubin (SBR) level greater than or equal to 272 mumol/L) with no assigned cause and breast feeding. The rates of breast feeding at hospital discharge increased from 46.4 to 75.4% in non-insured (public) women and 58.6 to 89.2% in insured (private) women between 1975 and 1987, and were accompanied by an increase in severe hyperbilirubinaemia from 1.6 to 3.1% in public and 0.9 to 3.6% in private babies. The case control study involved 125 term breast feeding infants born between 1 July 1985 and 1 July 1986 with severe hyperbilirubinaemia (SBR level 272 mumol/L) with no assigned cause who were compared with 125 matched controls who had peak SBR levels less than or equal to 272 mumol/L. Severe hyperbilirubinaemia was associated with primiparous and non-Caucasian mothers, non-smoking and oxytocin usage. Univariate analysis of feeding practice variables revealed that less frequent breast feeds, greater weight loss and less frequent stools over the first 3 days related to severe hyperbilirubinaemia (P less than 0.05). Multivariate analysis of the eight significant univariate factors revealed that maternal non-smoking, less frequent breast feeding, less frequent stooling and excessive infant weight loss were the best predictors of severe hyperbilirubinaemia. With the wide promotion of breast feeding, the contribution of individual feeding practices to severe hyperbilirubinaemia demands ongoing analysis and review.     

Infant feeding practices in rural Bangladesh

A longitudinal study was done on the infant feeding practices in a rural area. One hundred and ten infants were followed up from birth to 1 year of age by alternate day home visits, to enquire about the type of food, and frequency of consuming it. It was found that 100% mothers breast-fed their infants from birth to 1 year, almost every day. But, bottles containing various kinds of milk and starchy food were added to 60% of infants diets by 3 months, and 80% by 5 months of age. This additional food was given mostly in diluted form, which was more so in case of tinned milk. Family food such as rice and vegetables were given in 30% and 40% child days respectively from 6 months to 1 year. Rural people withhold protein food and fruits during infancy. It is concluded, that infant feeding practices in our population is improper and mothers should, therefore, be trained and motivated on weaning practices for timely and adequate supplementation to ameliorate the presently observed dietary deficiency and early malnutrition in rural Bangladesh.     

Relationship of breast feeding versus bottle feeding with emergency room visits and hospitalization for infectious diseases

Breast-feeding habits of 480 Jewish infants visiting a pediatric emergency room (ER) with infectious diseases were compared to those of 502 healthy infants visiting maternalchild health centers (MCH). (These centers are attended by almost 100% of the Jewish infant population.) Among infants under 5 months of age with acute gastroenteritis and upper respiratory infections, breast feeding was significantly less prevalent than among age-matched infants in the MCH group (22.6%, 18.5% and 53.4% respectively,P<0.0001). Infants with acute otitis media and lower respiratory tract infections showed the same trend although the numbers were small. A very short breast-feeding period of 2 weeks or less was more prevalent among the ER group and was associated with increased hospitalization rate. These data emphasize the importance of breast milk in reduction of ER visiting and hospitalization rate.     

Breast feeding in neonatal alloimmune thrombocytopenia

Infants with neonatal alloimmune thrombocytopenia are at risk of severe intracranial haemorrhage. Placental transfer of maternal immunoglobulin G (IgG) directed against fetal platelet antigens is known to be the underlying mechanism. Since breast milk contains IgG it is theoretically possible that breast feeding of these infants could cause thrombocytopenia. The following case report shows that an infant with neonatal alloimmune thrombocytopenia may be safely breast fed, even when the breast milk contains the platelet specific antibody (HPA-1a).     

Risk factors for early termination of breast feeding in Brazil

A prospective study was undertaken to identify possible factors related to the duration of breast feeding. Two hundred and thirty-eight mothers who had delivered normal single babies with birth weights greater than 2.5 kg and had initiated breast feeding were randomly selected at the maternity hospital, Hospital de Clinicas de Porto Alegre, Brazil, and followed by mail questionnaires until termination of breast feeding, or until the end of the first year. If no reply was received, telephone contact or home visits were made. The group of mothers who stopped breast feeding prior to the end of the third month was compared with those who extended breast feeding beyond three months with respect to socioeconomic, biological, environmental, medical and psychological factors. The variables with a significant coefficient of association with early termination of breast feeding were maternal education, past experience with breast feeding, help of a maid, help with housework provided by a relative, breast feeding orientation during prenatal care and encouragement from the husband. These factors act simultaneously, with interactions among them.     

Breast feeding and childhood hematological malignancy

Breast milk is known to have anti-infective and immunomodulating effects on infants, but its association with childhood cancer has not been well studied. Artificial feeding may affect the immune response in carcinogenesis. In this communication the authors have reviewed different articles describing the association between breast feeding (BF) and subsequent development of childhood hematological malignancy. It appears that BF may have a protective effect on childhood cancer, both the duration of BF as well as the quantity of milk ingested is probably critical to the beneficial immunological effects of BF against childhood cancer if any.     

Breast feeding pattern in urban infants in Chandigarh

The pattern of breastfeeding and the factors which determine the practice were assessed in 670 mothers from urban areas of Chandigarh. Unsupplemented breastmilk was administered to only 36.6% of babies up until 4 months of age. Women from the lower socioeconomic class, uneducated, and poorly educated mothers were more successful than those from the upper socioeconomic clases or those with higher education (P0.01). The success rate for breastfeeding was higher among babies born at home (50.0%) as compared to those born in the hospital (32.3%). Similarly, high proportions of male infants were successfully breastfed (40.3%) as compared to females (31.6%). Among those infants weaned breastfeeding was discontinued before 1 month of age in more than 60%. The main reason that breastfeeding failed was insufficient milk. Promotional efforts for unsupplemented breastfeeding should consider some of the above factors for their success.     

Maternal attitude and practices in initiation of newborn feeding

The present study highlights the need for due emphasis on initiation of breast feeding of newborn infants over other traditional prelacteal newborn feeds. Knowledge, attitudes and newborn feeding practices amongst 702 mothers with urban background was recorded. Though 83.5% of mothers had attended the antenatal clinics, only 13.24% had been given breast feeding advice at the antenatal clinics. It is a cause of concern that only 26.35% had initiated the feeding by breast milk and only 16% had given colostrum. A large number of newborns were fed with finger tips and other unhygienic methods. However, most (95.01%) mothers had started breast feeding their newborns before discharge from hospital.