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Breastfeeding and use of the health care system in Bahia State, Brazil: three multivariate analyses.

Three multivariate methods--deviation from total proportion breastfeeding, polynomial regression, and proportional hazards--are used on current status breastfeeding data to explain an inverse relationship between use of the health care system and breastfeeding in Bahia State, Brazil. Among the intervening variables analyzed--urban/rural residence, educational attainment, age of woman, and place of last live birth--education and place of last live birth are found to have a net effect on breastfeeding by all three methods of analysis. The advantages and disadvantages of each method are described.

Adolescent↗

The effect of a culture-specific education program to promote breastfeeding among Vietnamese women in Sydney.

The rate of breastfeeding among immigrant Vietnamese women in Western countries is low compared to those in Vietnam. To counteract this trend, a language and culture specific education program was developed. An experimental design was used to test the effectiveness of this program. The sample consisted of 182 prenatal Vietnamese women. Data collection included questionnaires and interviews. Results suggested that the education program had significant effects on knowledge, attitudes, planned and actual behaviour towards breastfeeding. However, the effect did not sustain until 6 months postpartum. Implications for nursing practice and further research are discussed.

Adult↗

Determinants of breast-feeding and post-partum amenorrhoea in Orissa.

A life table analysis is made of the duration of breast-feeding and post-partum amenorrhoea in Orissa, India, taking one variable at a time using data from a baseline survey of fertility and mortality (BSFM) conducted on the lines of the World Fertility Survey. Then a multivariate (proportional hazard) analysis showed that socioeconomic factors including residence, caste status and education influence the breast-feeding and post-partum amenorrhoea periods. There was no effect of maternal age on the length of breast-feeding, but mean length of post-partum amenorrhoea varied with age. The durations of breast-feeding and post-partum amenorrhoea are strongly related.

Amenorrhea↗

Individual and community characteristics influencing breastfeeding duration in Vietnam.

This analysis of selected community and maternal characteristics influencing duration of breastfeeding in Vietnam utilized data from the 1988 Demographic and Health Survey and 1990 Accessibility of Contraceptives Survey available for the 4434 children born to 2769 women having their last birth between 1983-88. Explanatory variables included as covariates in the hazards model were mother's education, age of the mother at the time of the child's birth, birth order, and gender of the child, urban versus rural residence, infant mortality risk in the child's province, locality (mountains and highlands compared to delta and coastal), and region of the country (north, south). Indicators of development in the child's village included availability of electricity and public transportation. Breastfeeding duration was longer among the more highly educated women and among those women living in provinces with higher infant mortality. However, there were no significant differences in the duration of breastfeeding with variations among certain development characteristics of the village. Although there were regional differences in the duration of breastfeeding for the rural population, there were no regional differences for the overall population. There were no significant variations in the duration of breastfeeding by age of the mother, birth order or gender of the child. Although there were significant variations in duration of breastfeeding by some maternal and community characteristics, between 80-90 per cent of all women breastfeed for at least the first year of the child's life.

Adolescent↗

Determinants of delayed initiation of breastfeeding: a community and hospital study from Guinea-Bissau.

A prospective study on the timing of breastfeeding start in Bissau was undertaken in a periurban community (n = 734), and at the Central Hospital (n = 414). Only single, full-term, healthy children born by the vaginal route were included, the purpose being to characterize mothers who delay breastfeeding start for reasons not related to disease. Multivariate failure-time analysis (Cox' regression) was used to relate the child's age at breastfeeding start to a set of independent variables. In the community, those tending to delay breastfeeding start were mothers from the largest ethnic group in the country, mothers who had given birth at times other than the evening hours (6-12 pm) and mothers who had not attended antenatal clinics. At the hospital, delayed initiation was found among young mothers and mothers from one sparsely represented ethnic group. The most important determinant of delayed breastfeeding start was negative cultural ideas about colostrum.

Adult↗

The effect of changes in population characteristics on breastfeeding trends in fifteen developing countries.

BACKGROUND: Extended breastfeeding is known to benefit the health of children in developing countries and despite widespread expectations of a decline in breastfeeding in these countries, it has been demonstrated that the incidence and duration of breastfeeding are in fact increasing many countries. METHODS: In this paper, trends in breastfeeding duration are examined in 15 developing countries, using data from two comparable surveys for each country, the World Fertility Survey (conducted in the late 1970s) and the Demographic and Health Survey (conducted in the late 1980s). Multivariate regression models are used to examine differentials in breastfeeding behaviour across population subgroups in these countries for each time period, and these differentials are used to determine the extent to which the observed trends are due to changes in population characteristics and to what extent behaviour has changed within population subgroups. RESULTS: Results show that changes in the characteristics of the population have almost universally pushed breastfeeding durations in the downward direction. On the other hand, trends within population subgroups have been positive in all but two of the 15 countries examined. CONCLUSIONS: Changes in population characteristics can be expected to continue for most developing countries, exerting a downward pressure on breastfeeding. Policies that promote breastfeeding are needed to counter these changes, especially in the most vulnerable population subgroups.

Adult↗

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.

Adolescent↗

Breastfeeding practices in Chengdu, Sichuan, China.

Barriers to increased breastfeeding rates in Chengdu, Sichuan were investigated in 1992 and 1993. Responses of focus groups showed that ignorance about breastfeeding and belief that the mother's milk was inadequate, and lack of support from their families, places of employment, and the health system acted as barriers to the women's breastfeeding their infants up to the age of four to six months. Subsequently, 363 mothers of 4- to 12-month-old Chengdu infants were surveyed. Although most mothers in both studies said breastmilk was the best food for their infant up to age of four to six months, only about half of the mothers breastfed for longer than one month. Both studies showed that infants who roomed with their mothers after birth were more likely to have been put to their mother's breast earlier, fed colostrum, breastfed somewhat longer, and exclusively breastfed for a somewhat longer period, although their mothers' infant feeding knowledge did not differ. The researchers conclude that Chengdu health workers should teach parents and parents-to-be more about breastfeeding, and that rooming-in be expanded in Chengdu hospitals.

Breast Feeding↗

The effects of rooming-in on the success of breastfeeding and the decline in abandonment of children.

This study analyzed the effect of management of rooming-in, conducted in one of the regional hospitals in Thailand, on the success of breastfeeding. Data based on 2,000 infants born in 1987 and 1990 showed a significant improvement on separation time of infant and mother after delivery and predominant breastfeeding, where the infant's predominant source of nourishment has been breastmilk. Separation time was reduced from 6.3 +/- 3.2 to 1.62 +/- 0.42 hours and predominant breastfeeding was significantly increased from 85 to 99 percent. Data obtained from the community related to the initiation and predominant breastfeedings showed a significant increase (p less than 0.05). No significant difference was demonstrated, however, on current breastfeeding among infants who were delivery before and after initiation of the rooming-in system. Also analyzed were data on prevalence of deserted children. The findings showed a progressive reduction of deserted children after management of rooming-in. The study concludes that the practices of obstetricians were a key to successful breastfeeding. Promotion and management of rooming-in significantly improves the success of breastfeeding and reduction of deserted children in the hospital.

Breast Feeding↗