Assessment of breast-feeding promotion in hospitals and follow-up survey of mother–infant pairs in Germany: the SuSe Study

Abstract

Objective: To assess breast-feeding promotion in maternity hospitals and breastfeeding prevalences during the first year of life in mother-infant pairs in Germany. Design: Cross-sectional assessment of breast-feeding practices in a random sample of German maternity hospitals by use of a postal questionnaire. Follow-up of motherinfant pairs recruited in the participating hospitals to assess breast-feeding prevalences and infant feeding practices by use of a telephone interview 14 days after birth and food-frequency questionnaires mailed at the end of the 2nd, 4th, 6th, 9th and 12th month of life. Use of indicators for breast-feeding proposed by the World Health Organization (WHO) and the United Nations Children's Fund (UNICEF). Setting: Nation-wide survey. Subjects: One hundred and seventy-seven maternity hospitals, 1717 mother -infant pairs.Results: There were wide variations in breast-feeding promotion in hospitals as evaluated by the practice of the '10 Steps to Successful Breastfeeding' given by WHO and UNICEF for certification as a 'Babyfriendly Hospital'. Some steps (3,4,8) were practised in about 90% of the hospitals, others (steps 7, 9) in only 10%. Prevalences for exclusive (total) breast-feeding as defined by WHO were: 73% (86%) at discharge, 60% (85%) at 14 days, 42% (70%) at 2 months, 33% (59%) at 4 months, 10% (48%) at 6 months, ,1% (26%) at 9 months and 0 (13%) at 12 months. Conclusions: By use of indicators proposed by WHO and UNICEF, a differentiated insight into the breast-feeding situation in Germany has become possible. Moderate levels of breast-feeding promotion in hospitals resulted in almost satisfactory early breast-feeding prevalences but were not effective for long-term breast-feeding success in most mothers.

The influence of habitual protein intake in early childhood on BMI and age at adiposity rebound: results from the DONALD Study

“…47,48 In particular, dietary patterns and feeding regimes in infancy were found to be very similar to a nationwide study on breastfeeding and infant nutrition. 49 Thus, we think that our study may nevertheless serve as a valuable contribution to the discussion of the hypothesis that early protein intake influences later obesity risk.…”

Evaluation of dietary fibre intake from infancy to adolescence against various references – results of the DONALD Study

“…However, there is no theoretical reason to establish reference values and only few data on dietary fibre intake in this age group exist (Institute of Medicine, 2002). In Germany, weaning is starting with vegetables (primarily carrots), combined with potatoes, meat and plant oil, followed monthly by two cereal-containing paps (Kersting and Dulon, 2002). Therefore, in the DONALD Study the dietary fibre intakes were somewhat higher than those proposed by Agostoni et al (1995).…”

Duration of breastfeeding and risk of overweight in childhood: a prospective birth cohort study from Germany

“…[4][5][6][7] One study found a dose-response relationship only in crude analysis 8 and three studies found no statistically significant effect of duration of breastfeeding on overweight or obesity in later childhood. [9][10][11] Like in other countries, 12 the prevalence of breastfeeding has increased over the past decades in Germany, since the World Health Organization (WHO) and the United Nations Children's Fund (UNICEF) began their campaigns for breastfeeding in the 1980s, [13][14][15] and consequently the extent to which we can generalize from former studies remains limited. Furthermore, most studies have estimated the effect of breastfeeding duration on overweight by using the group of never breastfed children as reference group.…”