Breast feeding promotion in an urban and a rural Jamaican hospital

Breast feeding promotion has been a national priority in Jamaica since the mid-1970s. Despite this effort, breast feeding rates have continued to decline there, especially in urban areas. Studies of the role of health professionals in promoting breast feeding have shown that specific practices encourage breast feeding, while others discourage it. In the context of declining breast feeding in a nation committed to promoting it, the goal of this study was to explore the relationship between specific health professional practices, mothers' breast feeding, and mothers' knowledge of breast feeding in rural and urban Jamaica. To accomplish this goal, a structured interview was administered to 113 mothers of infants age 0-6 months at one urban (n = 62) and one rural (n = 51) hospital, regarding (1) physician and nurse practices known to affect breast feeding, (2) mothers' own breast feeding practices, and (3) mothers knowledge of breast feeding issues. Physician and nurse visits were also directly observed to confirm responses given to the questionnaire and to assess the resources devoted to teaching mothers about breast feeding. While extensive lectures, posters and pamphlets promoting breast feeding were provided for mothers at the urban hospital, far fewer educational resources were available for mothers at the rural hospital. Overall, however, health professional practices discouraging breast feeding were observed more frequently at the urban hospital than at the rural hospital, whereas practices promoting breast feeding were more common at the rural hospital. At the rural hospital, mothers' breast feeding practices more closely approximated recommendations than at the urban hospital.(ABSTRACT TRUNCATED AT 250 WORDS)     

A study of infant feeding practices in an urban Indian community

Thirty mothers, attending either a paediatric clinic at a Government hospital or a private paediatrician's surgery, both in Tirupati, Andhra Pradesh, South East India, were questioned about their infant feeding practices. A sample of milk from their child's bottle was requested and subsequently analysed for the presence of dilution. Over-dilution, defined as less than 75% of the standard concentration, was found to be common (P<.05). No significant correlations were found between the incidence of over-dilution and either family income or educational status of the mothers due to the small sample size. The study suggests the need for practical education on the reconstitution of milk feeds.     

Influences on infant–feeding beliefs and practices in an urban Aboriginal community

Abstract: The Victorian Aboriginal Health Service initiated a project to increase breastfeeding rates in the Melbourne Aboriginal community. The results of focus–group discussions on infant–feeding experiences and beliefs provided a wealth of information for the design of appropriate interventions. Most women wanted and expected to breast–feed. Some chose artificial feeding because of embarrassment, a belief that it is as good as breast–feeding, or perceptions that breast–feeding is painful and inconvenient. The most common reasons that women stopped breast–feeding were sore nipples, worries about their supply of milk and tiredness. Lack of knowledge, hospital practices, lack of support and appropriate advice, and lack of confidence and self–esteem contributed to these problems. Disruption of the passing on of knowledge of healthy infant–feeding practices between generations is another cultural loss suffered by Aboriginal communities. Efforts to restore traditional rates of breast–feeding need to be under Aboriginal control and to take account of these influences. ( Aust N Z J Public Health 1997; 21: 504–10)     

Breast feeding and weaning practices of urban housewives in Srinagar

Researchers interviewed 125 mothers in Srinagar, India about breast feeding and weaning practices. Overall the mothers were generally illiterate (52%), housewives (67.2%), Muslim (76%), and from a nuclear family (56%). 39% were in the low income group. Most of the children (48%) ranged for 6-12 months old. 96% of the children had been breast fed. Some of the reasons for breast feeding included nutritional quality, economical, pleased the mother, and made the infant feel secure. 65.8% breast fed their infants on demand. 65.7% weaned their infants between 7-9 months yet 52% believed breast feeding should continue to 18 months. 96% breast fed their infants while ill with diarrhea. 57% believed colostrum to be unhygienic and did not feed it to their infants. 72% decided to breast feed before becoming pregnant while 36% decided to bottle feed before pregnancy. 89% of illiterate mothers breast fed while only 45% of literate mothers did. Further, only 11.8% of the mothers whose family income was 1500 rupees/month breast fed whereas 47% in the lower and 41.2% in the middle income groups did. At 7-9 months, 69.8% of illiterate and 69.5% of literate mothers had already introduced semi solid foods. 78.3% of literate mothers gave semi solid foods to their infants 2 times/day, but only 11.6% of the illiterate mothers did so. Moreover 81.4% of illiterate mothers only fed their infants semi solid foods once a day. Literate mothers were more likely than literate mothers to feed their infants solid foods (75% vs. 46.2%), introduce them at an earlier age (22.2% vs 10%, 7-9 months), and feed them more often (55.5% vs 16.6%; twice a day). In conclusion, the higher the educational status the more likely mothers were likely to breast feed.     

Breast and bottle feeding in rural and urban South African children

We studied breast and bottle feeding in 1264 children aged 1–4 years from five South African communities using a questionnaire on feeding habits completed by trained interviewers. The proportion of infants breast feeding ranged from 73% to 94% for mean periods of 9–16 months. The group with the most consistent and prolonged breast feeding habits were rural black children. Different bottle feeding practices were used within the various communities. At the ages studied the types of infant feeding practice varied little within the groups although each group differed significantly from the others for the preferred feeding method.     

An injury prevention program in an urban African-American community.

OBJECTIVES. Injury is a major US public health problem, particularly in urban minority communities. This paper evaluates the impact of the Safe Block Project, a comprehensive injury prevention trial, on home hazards and injury prevention knowledge in a poor urban African-American community. METHODS. Nine census tracts in the community were allocated to either the intervention area or the control area. The intervention, carried out by trained community outreach workers, consisted of (1) home modification for simple prevention measures, (2) home inspection accompanied by information about home hazards, and (3) education about selected injury prevention practices. Approximately 12 months after the intervention, random samples of control and intervention homes were assessed for home hazards and injury prevention knowledge. RESULTS. A significantly larger proportion of intervention homes than control homes had functioning smoke detectors, syrup of ipecac, safely stored medications, and reduced electrical and tripping hazards. No consistent differences were observed between control and intervention homes on home hazards requiring major effort to correct. CONCLUSIONS. There was a distinct difference between control and intervention homes with respect to safety knowledge and home hazards requiring minimal to moderate effort to correct. The Safe Block Project could serve as a model for future urban injury prevention efforts.     

The potential for community exposures to pathogens from an urban dairy

The objectives of the study described in this article were to evaluate the variation and transport of fungal and bacterial concentrations in the air of a northern Mexico dairy cattle confined animal feeding operation (CAFO) and to determine the concentration and incidence of antibiotic-resistant Staphylococcus aureus isolates. Two-stage viable cascade impactors were used to measure the culturable airborne fungal organisms and bacteria. S. aureus resistant to penicillin, ampicillin, or cefaclor was identified. Samples were collected at three locations that were designated as on site, upwind of the cattle, and downwind of the cattle. The highest concentrations of culturable bacterial bioaerosols were consistently recovered from the on-site location. More than half of the organisms were antibiotic resistant at the on-site location. Elevated levels of culturable bacterial bioaerosols were recovered from the upwind site that may have been associated with the surrounding community. Bioaerosol concentrations were found in higher amounts than in a facility in the southwestern U.S. examined in the authors' previous study. The urban setting of the CAFO resulted in a higher potential for immediate community exposures.     

The yield of cholesterol screening in an urban black community.

BACKGROUND: While the distribution of cholesterol levels have been well studied in the general population, little is known about cholesterol and other cardiovascular disease risk factors in screenings held in an urban Black community. This study was designed to determine the yield of cholesterol screening in this community. METHODS: Screening took place in eight community sites. Serum total cholesterol was measured using a rapid capillary technique. Blood pressure was taken according to national guidelines and the average of two to three measurements were used. Standard interviews were used to determine the presence of cardiovascular risk factors by history. RESULTS: Of the 562 individuals screened, 44.9 percent had cholesterol levels requiring referral for follow-up care. Of those with total cholesterol greater than or equal to 6.21 mmol/L, 66.4 percent were previously undetected and more than half also had blood pressure levels greater than or equal to 140/90 mmHg on screening; 45 percent of all participants had blood pressure greater than or equal to 140/90 on screenings. Of those with a history of elevated total cholesterol levels, none had levels below 5.17 mmol/L at the time of screening. CONCLUSIONS: Multiple risk factors are highly prevalent in the urban Black community during cholesterol screening programs. Findings suggest the need for cholesterol programs incorporating blood pressure screening in the urban Black community.     

Implementing a directly observed therapy program in an urban community hospital.

St. Clare's Health and Hospital Center has implemented a directly observed therapy (DOT) program for a challenging urban population of largely HIV+ patients in response to a need for the prevention of the spread of multidrug-resistant tuberculosis in the population. Identified treatment barriers are needs of patient subgroups within the population. Issues in the implementation include: patient compliance, effectiveness of patient identification and follow-up, and continuity of care. Challenges to continuity of care include patients signing out of the hospital against medical advice and missed clinic appointments. Patient identification and follow-up is enhanced by coordinating DOT treatment with the methadone maintenance treatment program.     

Breast feeding and nutritional status in depressed urban areas of greater manila,Philippines

Marasmic infants were weaned from the breast earlier than nutritionally normal infants in depressed areas of Greater Manila, Philippines. However, bottle feeding was not a statistically significant cause of malnutrition in a sample of 513 six to forty‐eight month old children. Marasmic children were affected by other significant variables such as monther's education, birth order, morbidity, parental employment, and family stability.

Among six to twelve‐month‐old infants, mean weight for age of those bottle‐fed or weaned by two months was slightly greater than for those still breast‐fed, although both groups were severely malnourished. Incidence of bottle feeding was highest in depressed neighborhoods in which the nutritional status of infants was highest.

Because poor urban Filipina mothers, with an average sixth grade education, do bottle‐feed as adequately as they breast‐feed, they could theoretically feed their infants well if instead of purchasing milk they breast‐fed and used the savings to buy weaning foods.     

Breast feeding and nutritional status in depressed urban areas of Greater Manila,Philippines

Marasmic infants, weaned from the breast earlier than nutritionally normal infants, were found in depressed areas of Greater Manila, Philippines. Bottle feeding was not a statistically significant cause of malnutrition in a sample of 513 6 to 48 month old children. Other significant variables were mother's education, birth order, morbidity, parental employment, and family stability. The mean weight for age of those bottle fed or weaned for 2 months was slightly greater than for those still breast fed. Both groups were severely malnourished. Incidence of bottle feeding was highest in depressed neighborhoods where the nutritional status of infants was the highest. If poor Filipina mothers, with an average sixth grade education, bottle feed as adequately as they breast feed they would be better off breast feeding, and spending the saved money on weaning foods. The positive correlation between the nutritional status of the infant and the mother's education suggest that education for girls in school could have a beneficial effect on infants' nutrition.