An exploration of the knowledge and attitudes towards breastfeeding among a sample of Chinese mothers in Ireland

Background  

Psychological factors are important in influencing breastfeeding practices. This retrospective study explored knowledge and attitudes related to breastfeeding of Chinese mothers living in Ireland.     

Clinical and epidemiological determinants of sodium and potassium levels in the colostrum of breastfeeding mothers with and without hypertension in Brazil

This study aimed to determine whether maternal hypertension and other clinical and epidemiological determinants have an impact on sodium and potassium levels in the 48-hour colostrum of breastfeeding mothers. The study included 105 randomly selected breastfeeding mothers, of whom 72 (68.8%) had normal blood pressure and 33 (31.4%) were hypertensive. Colostrum was collected in-hospital in the morning, and sodium and potassium concentrations were measured using a flame photometer. When sodium and potassium concentrations were compared to the variables age, parity, family history of hypertension, gestational age, birth weight, and socioeconomic factors, colostrum potassium level was associated with maternal age. Average sodium and potassium levels in 48-hour colostrum non-hypertensive and hypertensive breastfeeding mothers showed no significant differences. Thus, breastfeeding by hypertensive mothers probably does not increase the risk of their children developing hypertension in adulthood.     

Psychological effects of breastfeeding on children and mothers

While the nutritional and physical health benefits of breastfeeding are well established, accumulating research demonstrates the far-reaching psychological effects of breastfeeding on children and their mothers. Here, we provide a non-exhaustive review of the empirical evidence, showing that breastfeeding impacts children’s brain, cognitive, and socio-emotional development. In mothers, research is presented indicating that breastfeeding influences mood, affect, stress, and maternal care. The current review aims to provide a broad overview of existing findings on the psychological effects of breastfeeding, highlighting the important role that breastfeeding plays across several dimensions of psychological functioning. We also discuss the potential mechanisms that may underpin the observed effects, provide a constructive commentary on the limitations of the existing work, and put forth some considerations when evaluating this line of research.

     

Attitudes and practices of breastfeeding mothers regarding fasting in Ramadan

OBJECTIVE: To investigate the attitudes and practices of breastfeeding mothers regarding fasting in Ramadan. DESIGN: Cross-sectional observational survey. SETTING: Well-child care clinic at Ankara University Medical School and a health station serving an impoverished population in Ankara, Turkey. PARTICIPANTS: Breastfeeding mothers of infants aged 12 months or younger. MAIN OUTCOME MEASURES: Fasting during Ramadan. RESULTS: Of the 164 participating mothers, 61 (37%) were from the health station and 103 (63%) from the university clinic. Most mothers were older than 25 years of age (55%), had more than primary school education (64%), a single child (53%), were living in a nuclear family setting (70%), supplementing breastfeeding (73%) and fasting (52%). Among the 129 mothers of infants aged 6 months or younger, 22% perceived a decrease in their breast milk and 23% an increase in the amount of solid supplements the infant was receiving. Belief that breastfeeding mothers should fast (RR = 6.45, 95% CI: 2.44-17.06), that fasting does not decrease breast milk (RR = 6.24, 95% CI: 1.85-21.05), receiving well-child care at the health station (RR = 3.14, 95% CI: 1.33-7.44), giving supplements (RR = 2.82, 95% CI: 1.09-7.27) and having multiple children (RR = 2.78, 95% CI: 1.23-6.28) were associated with fasting, in a logistic regression model. CONCLUSIONS: Fasting by breastfeeding mothers of infants is common during Ramadan, and rates are affected by beliefs of mothers on the effects of fasting on breastfeeding. We believe that child health care providers need to be knowledgeable about religious and cultural phenomena, study the effects of Ramadan fasting and form links with Islamic teachings to find religiously and culturally appropriate methods to combat the possible unfavourable effects for infants and children.     

Attitudinal and demographic correlates of food supplementation practices

Attitudinal and demographic correlates to food supplement use were ascertained for 689 adults residing in seven Western states. Of the 689, 372 (54%) were food supplement users and 317 (46%) were non-users. The only attitudinal variable significantly (p less than .001) related to the practice of food supplementation was the belief that vitamin C could cure and prevent a cold. More users than non-users agreed with the statement that "vitamin C can both prevent and cure a cold." Demographic variables found to be significantly (p less than .05) related to food supplement use included education, marital status, home type, employment status, and population of town/city in which the respondent resided. Food supplement users tended to be living together without marriage, never married, or divorced and living in town houses or "other" types of dwellings. More users than non-users resided in communities with populations of 2,500 or in communities with populations of 10,000 to 49,999.     

Couples' immigration status and ethnicity as determinants of breastfeeding

OBJECTIVES: We investigated how couples' immigration status and ethnicity determined the decision to initiate breastfeeding and to breastfeed at 6 months. METHODS: From data collected on 4207 mothers and 3013 fathers participating in a longitudinal birth cohort study, we used linear regression and covariate-adjusted proportions to estimate the determinants of breastfeeding behaviors. The sample was divided by immigration status (either foreign born or born in the United States) and further subdivided by ethnicity (Mexican Hispanic, non-Mexican Hispanic, and non-Hispanic). RESULTS: Mothers born in the United States had an 85% reduction in the odds of breastfeeding as compared to foreign-born mothers and a 66% reduction in the odds of breastfeeding at 6 months. Each additional year of US residency decreased the odds of breastfeeding by 4%. These differences by immigration status were seen for Mexicans, other Hispanics, and non-Hispanics. CONCLUSION: The Hispanic paradox may extend to other non-Hispanic immigrants for breastfeeding behaviors, but may not be true for Hispanic mothers born in the United States. Low rates of breastfeeding for Hispanic American mothers indicate that they should not be overlooked by breastfeeding promotion programs.     

Knowledge about breastfeeding in mothers of infants with gastroesophageal reflux

Infants with gastroesophageal reflux disease (GERD) who are breastfed have significantly shorter clinical episodes of the condition than artificially fed infants. The purpose of this study was to identify the knowledge about the benefits of breastfeeding in mothers of babies 0-12 months of age with gastroesophageal reflux. A non-probabilistic sample was taken among patients from various private radiological centers. Sixty mothers completed a self-administered questionnaire, with a median age of 26 years and an educational level of 14 years. Seventy one percent breastfed their last baby, but only 18.6% practiced exclusive breastfeeding. The pediatrician suggested formula to 53.3% of the mothers, and 64% of the mothers were told to combine breast milk with vegetables as treatment for the GERD. Inadequate knowledge about the benefits of breastfeeding was exhibited by 27% of the mothers. Mothers of infants with GERD need education on the importance of breastfeeding. Further research is necessary on the factors which impact the duration of breastfeeding in this population.     

Attitudes and subjective norms of Quebecian adolescent mothers towards breastfeeding

OBJECTIVES: To describe the attitudes and subjective norms of female adolescents toward breastfeeding, and to determine whether these are influenced by age, education level, mother tongue, place of birth, exposure to breastfeeding and intention to breastfeed their children. METHOD: 236 female adolescents, from four schools randomly selected among those offering education levels from secondary 1 to V 4, answered a questionnaire based on the theory of reasoned action. RESULTS: Female adolescents showed overall positive attitudes towards breastfeeding, but negative subjective norms. Older girls who were breastfed as infants and who originated from foreign countries showed the most positive attitudes towards breastfeeding. INTERPRETATION: Even though adolescent girls showed overall positive attitudes, several were unable to make up their mind. This result could be attributed to a lack of knowledge and low exposure to breastfeeding mothers. The school system plays an important role in health promotion and should expose all students to the art of breastfeeding through its health classes.     

Long-term neighborhood poverty trajectories and obesity in a sample of california mothers

Neighborhoods (and people) are not static, and are instead shaped by dynamic long-term processes of change (and mobility). Using the Geographic Research on Wellbeing survey, a population-based sample of 2339 Californian mothers, we characterize then investigate how long-term latent neighborhood poverty trajectories predict the likelihood of obesity, taking into account short-term individual residential mobility. We find that, net of individual and neighborhood-level controls, living in or moving to tracts that experienced long-term low poverty was associated with lower odds of being obese relative to living in tracts characterized by long-term high poverty.     

Parenting behaviour described by mothers in a general population sample

OBJECTIVES: To collect mothers' reports of the range of behaviours used by them in the management of their children's difficult behaviour. DESIGN: A cross-sectional study using an interview with both semi-structured and open-ended question routes. SAMPLING FRAME: The population of mothers with 10-year-old children living in the New Forest region of Hampshire, UK. METHODS: Mothers (n=67), selected from the sampling frame, were interviewed about the range of parenting behaviours they used in the management of their children's difficult behaviour. RESULTS: Mothers reported a wide range of behaviours. Both authoritative (e.g. reasoning was mentioned by 42%) and authoritarian (e.g. the use of physical punishment was mentioned by 37%) behaviours were mentioned frequently. Although the different behaviours within these domains were intercorrelated, there was little overlap between the two domains. The use of praise for good behaviour seemed to be independent of other behaviours. There was no association between mothers' parenting behaviours and the behaviour problems of their children. CONCLUSIONS: These data suggest that parenting takes many forms, with variations of behaviour across the 'normal' range being unlikely to represent a significant risk to children's development. Public funding for parenting education should be targeted at those children who are at significant risk from extreme forms of parenting.     

Birth intervals, breastfeeding and determinants of childhood mortality in Malawi

Childhood mortality in Malawi is analyzed by employing proportional hazards models. The analysis uses highly reliable data collected from the 1992 Demographic and Health Survey (DHS) of Malawi. The results show that the substantial birth interval and maternal age effects are largely limited to the infant period. The influence of social and economic variables on the mortality risk and on the relationship between biodemographic variables and mortality risk is much enhanced with increasing age of the child. It has also been found that consideration of breastfeeding status of the child does not significantly alter interpretation of effects of preceding birth interval length on mortality risk, but does partially diminish the succeeding birth interval effect. The results are discussed and then summarized in the context of policy implications for Malawi. The paper addresses a very important issue in Malawi and it adds valuable insights to the base of knowledge in childhood mortality in sub-Sahara Africa.     

Controlling feeding practices and psychopathology in a non-clinical sample of mothers and fathers

OBJECTIVE: To explore the relationships between controlling feeding practices and a range of mental health symptoms while considering both parent and child gender. METHOD: Mothers and fathers (N=214) of children aged 18-59 months completed self-report measures of their child feeding practices, eating psychopathology and general mental health symptomology. RESULTS: Feeding practices did not differ across any of the four parent-child gender dyads. Mothers' eating psychopathology scores were significantly higher than fathers' but parents did not significantly differ in the severity of their other mental health symptoms. Associations between disordered eating symptoms and controlling feeding practices were only seen in mothers of daughters and fathers of sons. In general, a range of mental health symptomologies in this non-clinical sample were related to more controlling feeding practices across all four dyads. Psychopathology was most strongly related to controlling feeding practices in parents of girls. CONCLUSION: Symptoms of psychopathology may be more likely to associate with controlling feeding practices in parents of daughters due to societal values for slimness in females.     

Socio-economic and demographic determinants of under-five mortality in rural northern Ghana

Background

In spite of global decline in under-five mortality, the goal of achieving MDG 4 still remains largely unattained in low and middle income countries as the year 2015 closes-in. To accelerate the pace of mortality decline, proven interventions with high impact need to be implemented to help achieve the goal of drastically reducing childhood mortality. This paper explores the association between socio-economic and demographic factors and under-five mortality in an impoverished region in rural northern Ghana.

Methods

We used survey data on 3975 women aged 15–49 who have ever given birth. First, chi-square test was used to test the association of social, economic and demographic characteristics of mothers with the experience of under-five death. Subsequently, we ran a logistic regression model to estimate the relative association of factors that influence childhood mortality after excluding variables that were not significant at the bivariate level.

Results

Factors that significantly predict under-five mortality included mothers’ educational level, presence of co-wives, age and marital status. Mothers who have achieved primary or junior high school education were 45% less likely to experience under-five death than mothers with no formal education at all (OR = 0.55, p < 0.001). Monogamous women were 22% less likely to experience under-five deaths than mothers in polygamous marriages (OR = 0.78, p = 0.01). Similarly, mothers who were between the ages of 35 and 49 were about eleven times more likely to experience under-five deaths than those below the age of 20 years (OR = 11.44, p < 0.001). Also, women who were married had a 27% less likelihood (OR = 0.73, p = 0.01) of experiencing an under-five death than those who were single, divorced or widowed.

Conclusion

Taken independently, maternal education, age, marital status and presence of co-wives are associated with childhood mortality. The relationship of these indicators with women’s autonomy, health seeking behavior, and other factors that affect child survival merit further investigation so that interventions could be designed to foster reductions in child mortality by considering the needs and welfare of women including the need for female education, autonomy and socioeconomic well-being.

     

Genetic and nongenetic determinants of blood pressure in a southern Brazilian sample

A probabilistic sample representative of the adult population of Rio Grande do Sul, Brazil, was studied to estimate the genetic and nongenetic determinants of blood pressure. Four thousand five hundred and sixty-five individuals, 20 to 74 years old, from 2050 households, were examined. The genetic determination of the SBP (systolic blood pressure) and DBP (diastolic blood pressure) was evaluated in 557 families extracted from this sample. The analysis was performed first with no adjustments for other influencing factors, and then adjusting for the effects of the two significant covariates, age and Quetelet's index, identified through a multiple stepwise regression analysis with nine independent variables. Higher heritability estimates were obtained for DBP (raw data: 0.40; residuals: 0.45) than for SBP (raw data: 0.22; residuals: 0.26). The significant correlation coefficients varied from 0.13 (for father-offspring raw data, total sample), to 0.36 (for siblings, adjusted data, untreated sample). Slight differences were observed between the total and pharmacologically untreated samples in relation to correlation and heritability estimates.     

Price promotions for food and beverage products in a nationwide sample of food stores

Food and beverage price promotions may be potential targets for public health initiatives but have not been well documented. We assessed prevalence and patterns of price promotions for food and beverage products in a nationwide sample of food stores by store type, product package size, and product healthfulness. We also assessed associations of price promotions with community characteristics and product prices. In-store data collected in 2010–2012 from 8959 food stores in 468 communities spanning 46 U.S. states were used. Differences in the prevalence of price promotions were tested across stores types, product varieties, and product package sizes. Multivariable regression analyses examined associations of presence of price promotions with community racial/ethnic and socioeconomic characteristics and with product prices. The prevalence of price promotions across all 44 products sampled was, on average, 13.4% in supermarkets (ranging from 9.1% for fresh fruits and vegetables to 18.2% for sugar-sweetened beverages), 4.5% in grocery stores (ranging from 2.5% for milk to 6.6% for breads and cereals), and 2.6% in limited service stores (ranging from 1.2% for fresh fruits and vegetables to 4.1% for breads and cereals). No differences were observed by community characteristics. Less-healthy versus more-healthy product varieties and larger versus smaller product package sizes generally had a higher prevalence of price promotion, particularly in supermarkets. On average, in supermarkets, price promotions were associated with 15.2% lower prices. The observed patterns of price promotions warrant more attention in public health food environment research and intervention.     

Suicidal ideation and suicide attempts in a nationwide sample of operational Norwegian ambulance personnel

This is the first paper on suicidal ideation and attempts among ambulance personnel. This study aimed to investigate levels of suicidal ideation and suicide attempts among ambulance personnel, and to identify important correlates and the factors to which ambulance personnel attribute their serious suicidal ideation. A comprehensive nationwide questionnaire survey of 1,180 operational ambulance personnel was conducted. Measurements included: Paykel's Suicidal Feelings in the General Population questionnaire, the Hospital Anxiety and Depression scale, the Subjective Health Complaints Questionnaire, the Maslach Burnout Inventory, the Job Satisfaction Scale, the Basic Character Inventory, and the Rosenberg Self-Esteem Scale. Lifetime prevalence ranged from 28% for feelings that life was not worth living to 10.4% for seriously considered suicide and 3.1% for a suicide attempt. Serious suicidal ideation was independently associated with job-related emotional exhaustion (feelings of being overextended and depleted of resources) (OR 1.5, 95% CI 1.1-2.0) and bullying at work (OR 1.7, 95% CI 1.02-2.7), younger age, not married/cohabitant, depression symptoms, low self-esteem and the personality trait reality weakness. In general, suicidal thoughts were hardly attributable to working conditions, since only 1.8% of ambulance personnel attributed suicidal ideation to work problems alone. In conclusion, ambulance personnel reported a moderate level of suicidal ideation and suicide attempts. Although serious suicidal ideation was rarely attributed to working conditions in general, this study suggests that job-related factors like emotional exhaustion and bullying may be of importance.