Life Course Factors Associated with Initiation and Continuation of Exclusive Breastfeeding

Pitonyak, Jennifer S; Jessop, Amy B.; Pontiggia, Laura; Crivelli-Kovach, Andrea

doi:10.1007/s10995-015-1823-x

Cited by 28 publications

(25 citation statements)

References 26 publications

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“…Resultados semejantes se describen en el trabajo de Kelsey R. y cols 8 , en donde se evaluó la intención de amamantar más allá de los 3 meses, lo cual estaba estrechamente relacionado con el tiempo de reinicio de las actividades laborales, por tanto las probabilidades de no cumplir la intención de amamantar era mayor en las madres que retornan al trabajo antes de los 3 meses (OR: 2,25, IC 95% 1,23-4,12), entre las 6 semanas y 3 meses (OR: 1,82, IC 95% 1,30-2,56), comparadas con las madres que retomaban vida laboral posterior a los 3 meses. Los resultados de Jennifer S. Pitonyak y cols 15 , señalaron que la permanencia de los lactantes con sus madres trabajando desde la casa, se asociaba a mayor adherencia a la LME al cuarto mes (p = 0,0001). Además, el apoyo por parte del empleador se asoció a la continuidad de LME al cuarto mes o más (p = 0,02).…”

Section: Discussionunclassified

Impacto de la extensión del postnatal en la adherencia a la lactancia materna. Estudio de Cohorte

Muñoz

Cano

Rojas

2018

Rev. chil. pediatr.

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Recibido el 25 de julio de 2017; aceptado el 14 de mayo de 2018Palabras clave: Lactancia materna exclusiva; extensión del postnatal; adherencia ResumenIntroducción: En Chile, el año 2011 entró en vigencia la ley 20.545, correspondiente a la extensión del postnatal de 12 a 21 semanas. La Encuesta Nacional de Lactancia Materna (ENALMA), aplicada posterior al postnatal extendido, reportó un aumento del 12% en la adherencia a la lactancia materna exclusiva (LME) al sexto mes. Sin embargo, un 63% de las mujeres encuestadas eran laboralmente inactivas, por lo que las principales causas de cese de LM (lactancia materna) no estaban relacionadas con el tiempo de descanso materno. Objetivos: Calcular el impacto de los cambios en la adherencia a la LME en pacientes atendidos en control sano, en el período previo y posterior a la entrada en vigencia del postnatal extendido. Materiales y Métodos: Se realizó la extracción de datos de las fichas electrónicas del Centro Médico San Joaquín entre los años 2009 a 2013, los cuales fueron reclutados según criterios de inclusión y exclusión especificados (n = 938 pacientes). Posteriormente, fueron divididos en 2 grupos, según la presencia o ausencia de postnatal extendido, con seguimiento a los 3, 6 y 12 meses. Mediante tablas de frecuencia se realizó la caracterización de los grupos al comienzo del periodo de observación. Para evaluar homogeneidad de grupos, las variables del estudio se compararon entre los grupos mediante los test de chi cuadrado y Wilcolxon Mann-Whitney. Se comparó la prevalencia de mantención de LME mediante pr-test entre los grupos a los 3, 6 y 12 meses. Mediante análisis de sobrevida y regresión de Cox, se calculó el impacto del efecto del postnatal extendido entre ambos grupos en los primeros 12 meses. Resultados: Al comienzo de los periodos de observación, no se observaron diferencias entre los grupos en las variables estudiadas. Al comparar ambos grupos, sin y con postnatal extendido, no se encontraron diferencias significativas en la adherencia a la LME a los 3 meses: 327(66%) vs 302(68%), p = 0,492, respectivamente. En contraste, en el seguimiento a 6 y 12 meses se evidenció un aumento en la adherencia a la LME: 164 (33%) a 187 (42%), p = 0,004 y a los 12 meses; de 51 (10%) a 72 (16%), p = 0,007. Al analizar el impacto de la extensión del postnatal en la adherencia a la lactancia materna, determinado por la razón de riesgo, el postnatal extendido podría influir positivamente en la adherencia a la LME en el tiempo, con un HR < 1 (HR: 0,852, p = 0,04 IC 95%: 0,728-0,996). Conclusión: el aumento del tiempo de descanso materno, podría influir como factor protector de la adherencia a la LME. ARTÍCULO ORIGINAL IntroducciónLa lactancia materna (LM) es el alimento natural por excelencia, aporta inmunoprotección, nutrientes y fortalece el vínculo madre-hijo 1 . Las enfermedades diarreicas y respiratorias se presentan con menor frecuencia y gravedad en niños que reciben LM, incluso en situaciones donde existe higiene adecuada 2 . A largo plazo, los niños alimentados...

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Section: Discussionunclassified

Impacto de la extensión del postnatal en la adherencia a la lactancia materna. Estudio de Cohorte

Muñoz

Cano

Rojas

2018

Rev. chil. pediatr.

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“…Depression may need further investigation as a predictor for breastfeeding initiation among HIV-infected mothers, as our findings showed a trend towards significance. Some studies in high income countries, have demonstrated negative associations between the presence of perinatal depression and breastfeeding behaviours including intention and initiation 49 as well as duration of overall and exclusive breastfeeding 50,51 , but other studies, also in high-income countries, have shown no effect of perinatal depression on breastfeeding behaviours 52 . The lack of an association between IPV and negative breastfeeding outcomes also requires further investigation.…”

Section: Discussionmentioning

confidence: 99%

“…For both uninfected and HIV-infected mothers, interventions for breastfeeding initiation would need to address structural barriers relating to employment or work-place and facilitators to breastfeeding continuation 55 . Early return to work is a known risk factor for early discontinuation of breastfeeding 50 . For HIV-infected moms specifically, interventions for breastfeeding initiation would require an additional focus on individual factors to improve coping with HIV and a new baby.…”

Section: Discussionmentioning

confidence: 99%

Mental health predictors of breastfeeding initiation and continuation among HIV infected and uninfected women in a South African birth cohort study

Thomas

Kuo

Cohen

et al. 2017

Preventive Medicine

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Breastfeeding is a cost-effective, yet underutilized strategy to promote maternal and infant health in low and middle income countries (LMICs). Breastfeeding remains challenging for mothers living with HIV in LMICs, yet few studies have examined mental health predictors of breastfeeding initiation and continuation. We investigated breastfeeding among mothers by HIV status in South Africa, evaluating predictors of breastfeeding initiation and continuation to identify intervention-targets. Breastfeeding patterns were investigated in a subsample of 899 breastfeeding mothers from the Drakenstein Child Health Study; a prospective birth cohort of 1,225 pregnant women, between March 2012 and March 2015 in a peri-urban area. Breastfeeding was assessed at 5 time-points between 6 weeks and 24 months’ infant age. Cox proportional hazard models evaluated breastfeeding initiation and duration. Logistic regression models with breastfeeding non-initiation as the outcome parameter were performed to determine associations with maternal sociodemographic, psychosocial factors and gestational outcomes. More HIV-uninfected mothers initiated breastfeeding (n=685, 97%) than HIV-infected mothers (n=87, 45%). Median duration of exclusive breastfeeding was short (2 months), but HIV-infected mothers engaged in exclusive breastfeeding for longer duration than uninfected mothers (3 vs 2 months). Despite concerning high rates, mental disorders were not significant predictors of breastfeeding behaviour. Employment and HIV diagnosis during pregnancy predicted a lower likelihood of breastfeeding initiation among HIV-infected mothers, while employment was associated with earlier breastfeeding-discontinuation in HIV-uninfected mothers. Findings indicate that future interventions should target sub-populations such as HIV-infected women because of distinct needs. Workplace interventions appear particularly key for mothers in our study.

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“…As such, these studies have almost exclusively analyzed breastfeeding as an explanatory factor or predictor of later health and psychosocial outcomes for the child. To date, there are very few breastfeeding studies that explicitly utilize life course theory to explain breastfeeding behaviors themselves [Pitonyak, Jessop, Pontiggia, & Crivelli-Kovach, 2016;Whipps, 2017]. There is no theoretical reason for this to be the case.…”

Section: Current Theoretical Framework In Breastfeeding Researchmentioning

confidence: 99%

The Maternal Ecology of Breastfeeding: A Life Course Developmental Perspective

Whipps

Yoshikawa²,

Godfrey³

2018

Human Development

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Background/Aims: For mothers in high-income country contexts, infant feeding represents one of the most fundamental and challenging aspects of the transition to parenthood. We present a specific theoretical model, based on life course theory principles, to explicate how the maternal ecology influences breastfeeding behaviors throughout the early parenting years. Methods: Core concepts and suppositions draw from a review of extant theories for the development of infant feeding behaviors, including intraindividual models of health behavior and bioecological models of human development. We highlight where the model has strong evidentiary support and where there are gaps in the literature. Results: This review shows how life course theory has been used to describe the consequences of infant feeding behaviors, but has yet to be fully applied to the causes of those behaviors. The natural extension of life course theory to include these constructs and relationships will extend the field of breastfeeding research. Breastfeeding intervention could also be strengthened with more recognition of the life course factors that represent understudied, and thus underutilized, levers for intervention. Conclusion: Given its focus on personal history in a larger historical and ecological context, life course theory is well suited to framing discussions around the causes and consequences of breastfeeding.

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Life Course Factors Associated with Initiation and Continuation of Exclusive Breastfeeding

Abstract: Several factors associated with disparities in continued EBF were identified. The application of the LCHD framework furthers understanding of the multiple and interacting risks associated with early discontinuation of EBF.

Cited by 28 publications

References 26 publications

Impacto de la extensión del postnatal en la adherencia a la lactancia materna. Estudio de Cohorte

Impacto de la extensión del postnatal en la adherencia a la lactancia materna. Estudio de Cohorte

Mental health predictors of breastfeeding initiation and continuation among HIV infected and uninfected women in a South African birth cohort study

The Maternal Ecology of Breastfeeding: A Life Course Developmental Perspective

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