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An overview of importance of breastfeeding

January 2014
Journal of Comprehensive Pediatrics 5(2)

DOI:10.17795/compreped-14028

Authors:

Foad Alimoradi

Kurdistan University of Medical Sciences

Maryam Javadi

Qazvin University of Medical Sciences

Ameneh Barikani

Qazvin University of Medical Sciences

Naser Kalantari

Shahid Beheshti University of Medical Sciences

Show all 5 authorsHide

Context: According to some studies, the tendency of mothers to breastfeed has declined in recent years. Due to numerous benefits of breastfeeding which had been reported, this problem may put children's health and overall health of society at risk. In this study, we reviewed previous studies, emphasizing importance and necessity and enumerating benefits of breast-feeding. Evidence Acquisition: Databases including Science Direct, Biomed, Medline, Cochrane Library, EMBASE, SID, and magazines related to the topic were searched using keywords. Articles that examined various aspects of breastfeeding were analyzed as well. Results: The most perfect food for babies during the first two years of their lives is breast milk. It has so many health benefits for both mother and baby. Breastfeeding was studied from various aspects. There was significant correlation between the examined factors in vast majority of papers. However, some factors that researchers considered important did not give definitive results; therefore more extensive research is needed in this area. Conclusions: Breast milk is the most perfect food for babies during the first two years and no replacement is recommended during this time. Breastfeeding has so many health benefits for both mother and baby during the breastfeeding period as well as in the future.

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J Compr Ped. 2014 May; 4(2): e14028.

Published online 2014 May 1. Review Article

An Overview of Importance of Breastfeeding

Foad Alimoradi 1; Maryam Javadi 1; Ameneh Barikani 2,*; Naser Kalantari 3; Mohamad

Ahmadi 1

1Department of Nutrition, Faculty of Health, Qazvin University of Medical Sciences, Qazvin, IR Iran

2Department of Social Medicine, Faculty of Medicine, Qazvin University of Medical Sciences, Qazvin, IR Iran

3Department of Community Nutrition, National Nutrition and Food Technology Research institute, Faculty of Nutrition and Food Technology, Shahid Beheshti University of Medi-

cal Sciences, Tehran, IR Iran

*Corresponding author: Ameneh Barikani, Department of Social Medicine, Faculty of Medicine, Qazvin University of Medical Sciences, Qazvin, IR Iran. Tel/Fax: +98-2813341934, E-mail:

barikani.a@gmail.com

Received: August 4, 2013; Revised: February 17, 2014; Accepted: April 11, 2014

Context: According to some studies, the tendency of mothers to breastfeed has declined in recent years. Due to numerous beneﬁts of

breastfeeding which had been reported, this problem may put children’s health and overall health of society at risk. In this study, we

reviewed previous studies, emphasizing importance and necessity and enumerating beneﬁts of breast-feeding.

Evidence Acquisition: Websites including PubMed, Science Direct, Biomed, Medline, Cochrane Library, EMBASE, SID, and magazines

related to the topic were searched using keywords. Articles that examined various aspects of breastfeeding were analyzed as well.

Results: The most perfect food for babies during the ﬁrst two years of their lives is breast milk. It has so many health beneﬁts for both

mother and baby. Breastfeeding was studied from various aspects. There was signiﬁcant correlation between the examined factors in vast

majority of papers. However, some factors that researchers considered important did not give deﬁnitive results; therefore more extensive

research is needed in this area.

Conclusions: Breast milk is the most perfect food for babies during the ﬁrst two years and no replacement is recommended during this

time. Breastfeeding has so many health beneﬁts for both mother and baby during the breastfeeding period as well as in the future.

Keywords: Breastfeeding; Nutrition; Pediatrics

Implication for health policy/practice/research/medical education:

Decreased tendency of mothers to breastfeed in recent years may put children’s health and overall society health at risk. In this study, we reviewed previ-

ous studies to emphasize importance, necessity and enumerate beneﬁts of breast-feeding.

License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

1. Context

Breast milk is a unique source of food for babies (1, 2)

which contains all necessary nutrients that will ensures

the infant's health, growth and development (2). This

source of food cannot be replaced with any other diet, as

breast milk contains numerous antioxidants, protecting

babies against harm caused by pathogens (3, 4). Breast-

feeding is also an important source of antioxidants, such

as vitamin C and vitamin E, that prevent or reduce oxida-

tive damages to various body tissues (5). Many anti-in-

ﬂammatory agents were also found in breast milk which

protects child from inﬂammatory damage (6).

The breastfeeding period is the most critical period of

each individual’s life in terms of his growth and devel-

opment and an infant’s nutrition is highly important at

this stage. Secretary IgA of breast milk protects the ears,

nose, throat and digestive tract, also reduces intensity of

diseases such as diarrhea, respiratory tract infections (7,

8), otitis media, bacterial meningitis and urinary tract in-

fection (9). The carnitine level in infants fed with breast

milk is higher than infants fed with milk powder. Note

that carnitine is required for utilization of fatty acids as

an energy source (9). Exclusive breast feeding up to the

ﬁrst 6 months of an infant’s life reduces the risk of devel-

oping gastrointestinal infections (10), asthma (10, 11) and

increases prevention on development of childhood obe-

sity (12-15) and diabetes in later years of children’s lives

(16, 17) and may be associated with decreased cholesterol

concentrations (16). Also breast-fed children have higher

scores of mental-cognitive capability than children who

were not breast fed (18).

Breastfeeding signiﬁcantly reduced the risk of sudden

death syndrome in children under one year old (19-23)

and in early birth has a tremendous positive eﬀect on

children's health (24). On the other hand mothers who

had breastfed their babies are less likely to suﬀer from

hypertension (25) and with increased breastfeeding du-

ration decreased the risk of developing cardiovascular

disease in 50 year old mothers (26). Also were less prone

to develop breast cancer (27-29) and recurrence rate of

postpartum migraine (30, 31).

Alimoradi F et al.

J Compr Ped. 2014;4(2):e140282

2. Evidence Acquisition

In examining factors associated with breast milk, due to

extensive articles and topics related to this area of inter-

est, papers which stressed on the importance and ben-

eﬁts of breastfeeding were reviewed. The following key-

words were mostly looked up in articles: Breast Feeding,

Milk, Exclusive Breast Feeding, Women Milk, and Human

Milk. Sites that were used in this paper are as followed:

PubMed, ScienceDierect, Biomed, Medline, Cochrane Li-

brary, EMBASE, SID. Articles whose topics contradict this

article’s topic were considered as well.

Numerous studies have examined various aspects of

breastfeeding and breast milk feeding. There was a sig-

niﬁcant relationship between breastfeeding and critical

factors of human health in many of these studies. Given

the breadth of material in this ﬁeld of study, a summary

of examined reviewed studies are described individually

with respect to their topics in the rest of this paper.

2.1. Examining Relationship Between Breastfeeding

and Prevention of Diseases

Breastfeeding protects babies from many diseases and

reduces the severity of their symptoms. Among these dis-

eases we can mention respiratory infections, gastrointes-

tinal infections and diarrhea. Lower incidences of these

diseases were reported in infants fed with breast milk

(32-36). Salehi Abarghooyi et al. (37) showed that breast-

feeding longer than 12 months is eﬀective in reducing the

risk of myopia in six to seven years old children. A review

of several studies showed that breast milk contains bac-

teria that are disinfectants and strengthen the immune

systems of the infants’ bodies (38). Cornall (39) supported

the high impact of breastfeeding on growth and health

of skeletal system of children, compared to other nutri-

tional methods of breast feeding.

2.2. Examining the Relationship Between

Overweight and Obesity and Breastfeeding

Ibrahimzadekar et al. (40) showed that exclusive breast

feeding up to six months and its continuation until 18

months is eﬀective in reducing the risk of childhood

obesity. Some studies have shown that breastfeeding and

increased breastfeeding duration is an important factor

in reducing obesity and overweight in children (14, 41-

46). But, Shields et al. (47) and Nelson et al. (48) did not

ﬁnd an independent relationship between decreased

overweight and obesity and breastfeeding. Instead, they

found that other factors, including genetic and environ-

mental factors are involved in this relationship. How-

ever, in another study, Kramer et al. (11, 49) showed that

breastfeeding had no eﬀect on reducing obesity and over-

weight. Ijarotimi (50) study of 200 breastfeeding moth-

ers concluded that there was no signiﬁcant relationship

between breastfeeding mothers and their BMI. Burke et

al. (45) suggested in a study that children that are breast-

fed for less than four months are more likely to develop

obesity and overweight, or had increased obesity and

overweight, compared to children who had been breast

fed more than 4 months.

2.3. Examining the Relationship between

Breastfeeding and Incidence of Diabetes and

Hypertension

Several studies also supported the protective eﬀect of

breastfeeding against the development of type I diabetes

(17, 51). Meyer et al. (52) showed in their study of 167 ado-

lescents that breastfeeding is a protective factor against

type II diabetes in adolescents. In some studies linking

breastfeeding with reduced risk of type II diabetes has

been emphasized (53, 54). According to Villegas et al.

(53) and Stuebe et al. (55) studies, breastfeeding protects

both mother and child from type II diabetes. Stuebe et al.

(56) have also shown that breastfeeding protects mother

from hypertension; however other studies did not report

such an association (11, 57). Stuebe et al. (58) found that

the risk of developing type II diabetes in mothers who

tend to breastfeed their babies less than a month is more

than mothers who do not.

2.4. Examining the Relationship Between

Breastfeeding and Incidence of Asthma and

Allergies

In a case-control study of 400 cases and controls con-

ducted by Schnooyi et al. (59) it was shown that breast-

feeding up to six months is associated with a reduced risk

of asthma in 2-8 year-old children. Another study showed

that vitamin C found in breast milk reduces allergy in

children (6). Kramer et al. (60) study of 17046 children

did not conﬁrm the eﬀects of long-term breast-feeding

in reducing asthma and allergy. On the other hand, Sil-

vers et al. (61) reported a signiﬁcant relationship between

breastfeeding and lower respiratory disorders, especially

wheezing. Silvers et al. (62) showed that exclusive breast-

feeding may reduce asthma and allergies at age six years

old.

2.5. Examining the Relationship Between

Breastfeeding and Development and Function of

Nervous System

In a study of 69750 children conducted by Sun et al.

(63), it was demonstrated that persistent and long-term

breastfeeding is a protective factor against the develop-

ment of epilepsy in children. Several studies showed

that breastfeeding is eﬀective in increasing children's

cognitive understanding (18, 62, 64-66), in addition these

studies emphasized on long-term breast milk consump-

tion (62). Several studies also implied the positive role

of breastfeeding on increased IQ and mental abilities,

especially in language learning (67-69). This criterion is

Alimoradi F et al.

J Compr Ped. 2014;4(2):e14028

probably due to the presence of unsaturated fatty acids,

especially DHA, in breast milk (65, 70). Based on a case-

control study conducted by Al-Farsi et al. (71), breast milk

prevents the occurrence of autism in children. Another

study (72) also showed that the lack of breastfeeding or

early weaning of infants can make children vulnerable

to ADHA (Attention-deﬁcit/hyperactivity disorder). Nish-

ioka et al. (73) concluded in a study of 405 mothers that

mothers who breastfed their children for six months

were less prone to postpartum depression.

2.6. Examining the Relationship Between

Breastfeeding and Other Factors

The positive eﬀect of breastfeeding on the decreasing

risk of breast cancer was seen in mothers who had breast-

fed (27, 29, 58, 74). In two studies by Ram et al. (75) and

Gunderson et al. (76), it was shown that an increased

breastfeeding duration by mothers protects them

against metabolic syndrome in the following years after

weaning. Stuebe et al. (77) stated in a study of 89326 that

prolonged breastfeeding protects mothers from cardio-

vascular diseases. Schwarz et al. (78) found that increased

breastfeeding duration decreases the incidence of hyper-

tension, diabetes, cardiovascular diseases and Hyperlip-

idemia in mothers.

3. Results

This paper showed that breastfeeding is the most criti-

cal solution which helps both an individual [the baby]

and society because both mother and child beneﬁts from

the advantages of breastfeeding. The impact of breast-

feeding on reducing obesity and overweight were greatly

proven in children and adolescents. This issue can solve

many problems and diseases that society faces in the fu-

ture. The ﬁndings in the mentioned studies show that

breastfeeding reduces the risk of developing so many dis-

eases including diarrhea, respiratory infections, diges-

tive disorders, asthma, allergies and some neurological

disorders. Besides, breastfeeding can reduce obesity and

overweight in youths and adolescents. Other beneﬁts

of breast milk are its protective eﬀect in reduced risk of

developing diabetes, hypertension, metabolic syndrome

and breast cancer in mothers and children. Breastfeed-

ing prevents the risk of developing cardiovascular dis-

eases as well. The high concentration of anti-oxidant in

breast milk, leads to the conclusion that breast milk is a

protective factor against several numbers of cancers. So

far, no replacement has been proposed for breast milk.

4. Conclusions

Breast milk is the perfect food source - without any

other replacement - in children’s diet during the ﬁrst two

years of their lives. Further studies are still needed to ex-

amine the relationship between breastfeeding and other

health factors.

4.1. Recommendations

1) Child should be exclusively fed with breast milk in the

ﬁrst six months of his life.

2) Child determines breastfeeding time and any time

the child demands breast milk, he should be breastfed.

3) Breastfeeding should start from early hours after

birth.

4) Breastfeeding should continue after six months

along with complementary food for the child.

5) Mothers who cannot be near their children at all

times - for any reason - can freeze their milk, so that other

family members can feed the child with this milk when-

ever the child needs to be fed.

6) Do not deprive your children from breast milk as

long as it is possible.

Acknowledgements

Sincere thanks to Social Determinants of Health Re-

search Center, Qazvin University of Medical Sciences, Qaz-

vin, Iran for their helps.

Authors’ Contributions

Alimoradi 30%, Javadi 30%, Barikani 25%, Kalantari 10%,

Ahmadi 5%.

Financial Disclosure

This article did not use any ﬁnancial support and there

is no conﬂict of interests for authors.

Funding/Support

This research was supported by Qazvin University in

Medical Sciences, Qazvin Research Center for Social De-

terminants of Health, Qazvin, Iran.

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Mother and newborn skin-to-skin contact and timely initiation of breastfeeding in sub-Saharan Africa

Article

Full-text available

Jan 2023
PLOS ONE

Background Mother and newborn skin-to-skin contact (SSC) plays a key role in breastfeeding practices of mothers. In this study, we examined the association between mother and newborn SSC and timely initiation of breastfeeding in sub-Saharan Africa (SSA). Methods This cross-sectional study utilized nationally representative data from the Demographic and Health Surveys of 17 countries in SSA from 2015 to 2020. Multilevel binary logistic regression analysis was performed to examine the association between mother and newborn SSC and timely initiation of breastfeeding. The results are presented using adjusted odds ratios (aOR), with 95% confidence interval (CI). Results The pooled prevalences of mother and newborn SSC and timely initiation of breastfeeding were 45.68% (95% CI = 34.12–57.23) and 62.89% (95% CI = 55.67–70.11), respectively. Mothers who practiced newborn SSC were more likely to practice timely initiation of breastfeeding compared to those who did not practice SSC [aOR = 1.68, 95% CI = 1.58, 1.78] and this persisted after controlling for all the covariates [aOR = 1.38, 95% CI = 1.29, 1.47]. At the country level, mother and newborn SSC increased the odds of timely initiation of breastfeeding in Angola [aOR = 1.99, 95% CI = 1.44, 2.76], Cameroon [aOR = 1.43, 95% CI = 1.02, 1.99], Ethiopia [aOR = 1.62, 95% CI = 1.16, 2.28], Guinea [aOR = 1.69, 95% CI = 1.10, 2.60], Liberia [aOR = 2.03, 95% CI = 1.33, 3.12], Malawi [aOR = 1.47, 95% CI = 1.02, 2.12], Mali [aOR = 1.42, 95% CI = 1.10, 1.84], Sierra Leone [aOR = 1.87, 95% CI = 1.23, 2.83], South Africa [aOR = 2.59, 95% CI = 1.41, 4.76], Tanzania [aOR = 1.60, 95% CI = 1.27, 2.01], Uganda [aOR = 1.43, 95% CI = 1.02, 1.99], Zambia [aOR = 1.86, 95% CI = 1.50, 2.30], and Zimbabwe [aOR = 1.65, 95% CI = 1.24, 2.21]. Conclusion The prevalence of SCC was relatively low but timely initiation of breastfeeding was high. Mother and newborn SSC is a strong predictor of timely initiation of breastfeeding in SSA. To enhance timely initiation of breastfeeding after birth, this study recommends that more child and maternal healthcare interventions focused on improving mother and newborn SSC should be implemented.

Prevalence and Determinants of Exclusive Breastfeeding Among Mothers of Children Aged 6–24 Months in the Aseer Region

Article

Full-text available

Aug 2024

Background Exclusive breastfeeding (EBF) is crucial for infant and maternal health, providing optimal nutrition and immune protection for infants while reducing maternal postpartum depression and cancer risk. However, global trends show an early cessation of breastfeeding and the introduction of other foods. This study aims to determine the prevalence and factors influencing EBF among mothers in the Aseer region of Saudi Arabia. Methodology A cross-sectional study using a multistage cluster sampling approach was conducted from January to March 2024 in primary healthcare centers across the Aseer region. Participants included mothers of children aged 6-24 months attending primary healthcare centers for immunizations or routine check-ups. A pretested structured questionnaire, developed after an extensive literature review and expert consultation, was used to interview consenting participants. The questionnaire covered sociodemographic data, obstetric and medical history, child data, EBF practices, maternal knowledge and perception of breastfeeding, counseling about breastfeeding, antenatal care, breastfeeding support, and barriers and motivators of EBF. Results A total of 1,008 eligible mothers were included. Only 131 (13%) fulfilled the World Health Organization criteria for EBF. Moreover, 257 (25.5%) mothers initiated breastfeeding within the first hour after delivery, and 387 (38.4%) exclusively breastfed for six months or more. EBF was less frequent among mothers with higher education (8%, n = 2) compared to those with lower education (23%, n = 23, p = 0.017). EBF was also less frequent among mothers who delivered via cesarean section (7.9%, n = 28) compared to those who had a vaginal delivery (15.8%, n = 103, p = 0.001). Conversely, EBF was more common among mothers with more than five pregnancies (15.8%, n = 45) compared to those with one to two pregnancies (9.4%, n = 37, p = 0.023). EBF was also more common among mothers who had breastfed more than four children (16.7%, n = 39) compared to those who had not (12.1%, n = 49, p = 0.048). Finally, EBF was more common among mothers without postpartum complications (13.4%, n = 131) or whose infants had no birth complications (13.4%, n = 128) compared to their respective counterparts (p = 0.029 and p = 0.048, respectively). Conclusions This study found a low prevalence of EBF in the Aseer region, despite high maternal knowledge and positive perceptions. Factors such as low education, medical barriers, unemployment, and high parity were associated with increased EBF rates. Interventions should focus on improving workplace support and increasing maternal awareness of EBF recommendations.

KAP study on Breastfeeding and Weaning in a Low Socio-economic Area in Sudan, 2020-2021

Preprint

Full-text available

Apr 2024

Background: Breastfeeding is the gold standard of infant and young child feeding and an essential factor for their health and overall well-being. This study aims to assess the influence of socio-economic determinants on knowledge, attitude and practice of breastfeeding and weaning among mothers of children aged two years and below in the suburbs of Khartoum locality. Materials and Methods: A community-based cross-sectional study was conducted on 196 mothers of children selected through systematic random sampling. Results: Around 53% of participants had good knowledge on breastfeeding and weaning, and 60% of respondent had positive attitude towards breastfeeding and weaning. With regards to practice; breastfeeding initiation during the first hour was practiced by 94%, approximately 8% of participants had given pre-lacteal feed, colostrum feeding was done by 86.7%, around22% of women fed their child from one side until the whole breast is emptied out, 41% of mothers practicing breastfeeding on demand, 45% mothers had practiced or were currently practicing exclusive breastfeeding, almost 29% started introducing complementary food after the age of 6 month, and the most common types of complementary food introduced were boiled vegetables (94%). Socio-economic status significantly associated with poor knowledge were age below 25 years (p=0.007), primary education and below (p= 0.000) and mothers working in marginal business (p=0.008). While negative attitude was significantly associated with primary school education and below (p =0.04) and income of < or =10 000 Sudanese pounds per months (p =0.05). Mothers on marginal business jobs were more likely to have poor knowledge when compared to employed women (OR= 7.3, p 0.034). Those of primary education and below were likely to have poor knowledge than those with education level of secondary school and above (OR=4.8, p= 0.000). Whereas, those younger than 25years were more likely to have poor knowledge than older mothers (OR=2, p 0.026). Mothers who delivered at home had lower knowledge levels as to those who gave birth in a health institute (OR=2, p=0.019). Conclusion and recommendation: There is a need for mass education campaigns to promote optimal breastfeeding and weaning practices coupled with counseling during antenatal and postnatal periods

A scoping review of wet nursing in the Muslim world

Article

Aug 2022

The recruitment of wet nurses among Malaysians is increasing. This is due to the awareness on the benefit of breastmilk for infant’s growth and protection against diseases. However, the consequence of breastfeeding in Islam is tremendous, that is, the milk-mother and the child she breastfed are now become as blood mother and child. This means that a new set of family tie is formed between the nursling and the wet nurse’s family which needs to be addressed to avoid future problems such as health risk and incest if proper documentation and maintaining of family connection are not done. Since this phenomenon is quite new in the contemporary time, an understanding of this phenomenon is important to inform further action. Therefore, a scoping review was conducted to summarise and synthesise existing studies on wet nursing in the Muslim world. This is important to identify gap in literature on wet nursing in Islam. Thirty-nine articles which met the selection criteria were reviewed and classified according to the emergent themes. The themes were wet nursing from Islamic perspective; wet nurses and milk donors; history of wet nursing; experiences of wet nurses; breastmilk bank and milk donation; documentation of wet nursing; and father’s role in wet nursing. This review found a huge gap in literature specifically on how both the wet nurses’ and the nurslings’ families stay connected; and what needs to be done in terms of documentation to ensure easy tracing of family line in the future.

Knowledge, Attitude and Practices Among Mothers of Infants Regarding Breastfeeding

Article

Full-text available

Sep 2023

Objective: This study aims at understanding the level of knowledge, attitude, and practice of breastfeeding among mothers and the factors associated with good knowledge about breastfeeding. Materials and methods: A cross-sectional study among 251 mothers of infants admitted in the pediatric wards of SAT Hospital, Thiruvananthapuram was conducted during November-December 2019. The mothers of infants born between 37 and 42 weeks of gestation and without major birth defects were included in the study. The data were entered into an MS Excel sheet and analyzed using Statistical Package of Social Sciences version 26.0. Significance of association was tested using Chi-square test and multivariate analysis was done using binary logistic regression test. Results: The mean age of the participants was 26.25 (SD 4) years. On multivariable analysis, higher education and older age were found to be significantly associated with good knowledge. Independent sample T-Test results show that there was a statistically significant difference between the mean age of mothers with good knowledge (26.4(±4), 25.14(±3.7)), p-0.015 and statistically significant association was found between the mean attitude scores (34.07(5.58)) with current breastfeeding practices (p=0.002). Chi-square test shows that exclusive breastfeeding was significantly associated with the mother’s age (p=0.006); 64.2% of women practicing exclusive breastfeeding were less than 25 years of age. This study also demonstrated a significant association between the initiation of breastfeeding within an hour and exclusive breastfeeding (p=0.003). Conclusion: This study shows that mothers with higher age and higher educational qualifications were significantly associated with good knowledge about breastfeeding. Even though mothers have good knowledge, nearly half the mothers only exclusively breastfeed their infants for six months. Improving the educational qualification of women and increasing awareness about the benefits of breastfeeding among young women will promote breastfeeding practices.

Antimicrobial activity of whey milk and their fractions against Staphylococcus pasteuri clinical strain

Article

May 2023

Determinants of infant formula feeding in Debre Berhan city: A community-based cross-sectional study

Preprint

May 2024

Introduction: Exclusively breastfed infants experience more rapid growth in the first 6 months than other infants. This is because exclusive breastfeeding offers infants a food source (breast milk) that is packed with essential nutrients, immune boosting elements, and other biologically active compounds crucial for optimal growth and development. However, owing to the increasingly expanding market for breast milk substitutes, the duration of breastfeeding is declining worldwide. Objective: To assess the determinants of infant formula feeding among mothers of infants aged 0-6 months in Debre Berhan city, 2023 Methods and Materials: Between the 10th and 20th of May 2023, a total of 656 mothers were selected by employing a multistage sampling technique. The data were collected using a semi structured questionnaire, and the results are presented using frequencies, percentages, and graphs. In addition, bivariate and multivariable logistic regression models were employed to identify predictors of infant formula feeding. According to the multivariable logistic regression models, variables with a p value less than 0.05 were considered statistically significant predictors of infant formula feeding, and the adjusted odds ratio (AOR) was used to indicate the degree of association between the predictor variables and infant formula feeding. Results: According to our study, 39.7% of the mothers in Debre Berhan city practiced infant formula feeding. In addition, mothers who were aged 25 to 34 years [AOR = 2.68, 95% CI: 1.26, 5.70] or 35 to 45 years [AOR = 4.74, 95% CI: 1.86, 12.1], primipara [AOR = 4.48, 95% CI: 2.69, 7.45], had received antenatal care (ANC) [AOR = 2.26, 95% CI: 1.74, 5.06], had delivered through the caesarian section (C/S) [AOR = 4.28, 95% CI: 2.12, 8.65], not aware of the risks of infant formula feeding [AOR = 7.26, 95% CI: 4.09, 12.85], or who had initiated breastfeeding after an hour of birth [AOR = 5.27, 95% CI: 3.14, 8.85] were more likely to feed their babies infant formula. Conclusion: Our findings suggest a high prevalence of infant formula feeding in Debre Berhan city, and the majority of the factors that lead to infant formula feeding are modifiable if proper interventions are implemented.

Determinants of Exclusive Breastfeeding Among Mothers of Infants Less Than Six Months of Age in Mogadishu: A Facility-Based Cross-Sectional Study

Article

Jan 2024

Background Breastfeeding is a vital practice for infant health and well-being, with exclusive breastfeeding (EBF) during the first six months being particularly crucial. Despite its benefits, EBF is sub-optimally practiced in many low-to-middle income countries. This study focuses on Somalia, a country with historical political instability and poor health indicators, aiming to identify the prevalence and determinants of exclusive breastfeeding among women with infants under six months attending SOS Mother and Child Hospital in Mogadishu. Methods A hospital-based cross-sectional design was used, and data were collected through a structured questionnaire. The study sample consisted of 345 mothers, selected using a systematic sampling technique. Descriptive, bivariate, and multivariate analyses were conducted to assess breastfeeding practices and determine factors influencing exclusive breastfeeding prevalence. Result The study found that the prevalence of exclusive breastfeeding among the study population in Somalia was 44%, influenced by factors such as maternal education, employment, and utilization of antenatal and postnatal care services. Male infants and younger infants had higher odds of being exclusively breastfed. Conclusion and recommendations The study emphasizes the importance of promoting exclusive breastfeeding as the optimal feeding practice for infants in Somalia, highlighting the need for comprehensive health education during antenatal care visits and postnatal counseling. It recommends the development of supportive policies, such as maternity leave and workplace accommodations, along with community-based initiatives and support groups to facilitate and encourage exclusive breastfeeding practices.

Herbal medicine use and predictors among breastfeeding mothers attending primary healthcare centres in Lagos State, Nigeria

Article

Full-text available

Oct 2023

Ogochukwu Ukamaka Amaeze

Background: Herbal medicines are increasingly used globally and are a more affordable and accessible therapeutic option than conventional medicines. Little is known about their use in breastfeeding mothers and their potential effects on both mother and child. This study aimed to determine the prevalence, socio-demographic determinants, and commonly used herbal medicines among breastfeeding mothers in Lagos state, Nigeria. Methods: A cross-sectional survey of breastfeeding mothers attending primary healthcare centres across Lagos state was conducted. Data were collected using a structured and validated intervieweradministered questionnaire and analysed using descriptive and inferential statistics. The association between socio-demographic characteristics and herbal medicine use was assessed using bivariate analysis. Factors related to herbal medicine use were assessed using logistic regression and the effects were measured with odds ratio along with 95% confidence intervals. p-value <0.05 was considered significant. Results: Of the 400 respondents, 68.3% used herbal medicines for various reasons; however, only 7% reported using them for breastfeeding-related reasons. Herbal medicines were mainly used to treat malaria and typhoid fever (27%). 'Agbo,' a multi-herbal concoction (49%), was the most frequently used herbal medicine. Identified predictors of herbal medicine use included location, tribe, religion, parity, and occupation. Almost 60% of the mothers believed that herbal medicines are more effective than conventional medicines in treating certain illnesses Conclusion: Herbal medicine use is relatively common among breastfeeding mothers in Lagos, Nigeria. Factors related to herbal medicine use included religion, tribe, location, parity, and occupation. Herbal medicines commonly used by this population deserve further research for safety and efficacy for acclaimed use.

Knowledge, Attitude and Practice towards Exclusive Breastfeeding among Lactating Mothers visiting Sir Ganga Ram Hospital, Lahore: A Descriptive Cross-Sectional Study: Exclusive Breastfeeding among Lactating Mothers

Article

Full-text available

Jun 2023

Breastfeeding is important public health issues having numerous benefits for both infants and mothers but rates of exclusive breastfeeding remain low throughout the world. Several studies have investigated the factors that influence breastfeeding behaviors including maternal education, social support, and cultural beliefs. However, there is still much to be learned about the knowledge, attitudes, and practices of lactating mothers and how these factors affect breastfeeding outcomes. Objective: To assess knowledge, attitude, and practices of exclusively breastfeeding among lactating women attending Sir Ganga Ram Hospital. Methods: The cross-sectional study is carried out in Sir Ganga Ram Hospital, Lahore. The study is conducted in 4 months from February 2023 to May 2023. SPSS version 21.0 is used for data analysis. In this research, all individuals aged from 18 to 40 years; mothers having infant of from 0-24 months from Pediatric, Gynecology Wards and OPD were included. In exclusion criteria: non-cooperative mothers. Mothers with psychological problems were not bothered. Mothers with severely ill infants (e.g., cleft palate) Results: 54% of mothers were within normal ranges of BMI and only 4% were within the range of obesity. In our study, 46% of lactating mothers had 1-2 children and 13% had 5 or more than 5 children. 67% of mothers believed breastfeeding helped gain optimal weight gain.44% of mothers gave their child colostrums. About 28 Children <4 months were breastfed less than 4 times. Conclusion: The study shows that mothers were well informed and had proper knowledge, positive attitude and behavior towards breastfeeding. Most of the lactating mothers know the benefits of breastfeeding for 2 years.

Breastfeeding Promotion in Iran: Opportunities and Challenges

Article

Full-text available

Nov 2013

Breastfeeding and its Relationship with Reduction of Breast Cancer: A Review

Article

Full-text available

Nov 2012
ASIAN PAC J CANCER P

In this review, we describe the patterns of known immunological components in breast milk and examine the relationship between breastfeeding and reduced risk of breast cancer. The top risk factors for breast cancer are a woman's age and family history, specifically having a first-degree relative with breast cancer. Women that have a history of breastfeeding have been shown to have reduced rates of breast cancer. Although the specific cause has not been elucidated, previous studies have suggested that breastfeeding reduces the risk of breast cancer primarily through two mechanisms: the differentiation of breast tissue and reduction in the lifetime number of ovulatory cycles. In this context, one of the primary components of human milk that is postulated to affect cancer risk is alpha-lactalbumin. Tumour cell death can be induced by HAMLET (a human milk complex of alpha-lactalbumin and oleic acid). HAMLET induces apoptosis only in tumour cells, while normal differentiated cells are resistant to its effects. Therefore, HAMLET may provide safe and effective protection against the development of breast cancer. Mothers should be encouraged to breastfeed their babies because the complex components of human milk secretion make it an ideal food source for babies and clinical evidence has shown that there is a lower risk of breast cancer in women who breastfed their babies.

Effects of prolonged and exclusive breastfeeding on child height, weight, adiposity, and blood pressure at age 6.5 y: evidence from a large randomized trial

Article

Dec 2007

Background: The evidence that breastfeeding protects against obesity and a variety of chronic diseases comes almost entirely from observational studies, which have a potential for bias due to confounding, selection bias, and selective publication. Objective: We assessed whether an intervention designed to promote exclusive and prolonged breastfeeding affects children's height, weight, adiposity, and blood pressure at age 6.5 y. Design: The Promotion of Breastfeeding Intervention Trial (PROBIT) is a cluster-randomized trial of a breastfeeding promotion intervention based on the WHO/UNICEF Baby-Friendly Hospital Initiative. A total of 17 046 healthy breastfed infants were enrolled from 31 Belarussian maternity hospitals and their affiliated clinics; of those infants, 13 889 (81.5%) were followed up at 6.5 y with duplicate measurements of anthropometric variables and blood pressure. Analysis was based on intention to treat, with statistical adjustment for clustering within hospitals or clinics to permit inferences at the individual level. Results: The experimental intervention led to a much greater prevalence of exclusive breastfeeding at 3 mo in the experimental than in the control group (43.3% and 6.4%, respectively; P < 0.001) and a higher prevalence of any breastfeeding throughout infancy. No significant intervention effects were observed on height, body mass index, waist or hip circumference, triceps or subscapular skinfold thickness, or systolic or diastolic blood pressure. Conclusions: The breastfeeding promotion intervention resulted in substantial increases in the duration and exclusivity of breastfeeding, yet it did not reduce the measures of adiposity, increase stature, or reduce blood pressure at age 6.5 y in the experimental group. Previously reported beneficial effects on these outcomes may be the result of uncontrolled confounding and selection bias.

Duration of Lactation and Risk Factors for Maternal Cardiovascular Disease

Article

Jun 2010
Obstet Anesth Digest

Lactation and Incidence of Premenopausal Breast Cancer A Longitudinal Study

Article

Aug 2009
ARCH INTERN MED

Background: Findings from observational studies suggest an inverse association between lactation and premenopausal breast cancer risk, but results are inconsistent, and data from large prospective cohort studies are lacking. Methods: We used information from 60 075 parous women participating in the prospective cohort study of the Nurses' Health Study 11 from 1997 to 2005. Our primary outcome was incident premenopausal breast cancer. Results: We ascertained 608 incident cases of premenopausal breast cancer during 357 556 person-years of follow-up. Women who had ever breastfed had a covariate-adjusted hazard ratio (HR) of 0.75 (95% confidence interval [CI], 0.56-1.00) for premenopausal breast cancer compared with women who had never breastfed. No linear trend was found with duration of total lactation (P=.95), exclusive lactation (P=.74), or lactation amenorrhea (P=.88). The association between lactation and premenopausal breast cancer was modified by family history of breast cancer (P value for interaction =.03). Among women with a first-degree relative with breast cancer, those who had ever breastfed had a covariate-adjusted HR of 0.41 (95% CI, 0.22-0.75) for premenopausal breast cancer compared with women who had never breastfed, whereas no association was observed among women without a family history of breast cancer. Conclusion: In this large, prospective cohort study of parous premenopausal women, having ever breastfed was inversely associated with incidence of breast cancer among women with a family history of breast cancer.

The Association Between Duration of Breastfeeding and Adult Intelligence

Article

May 2002

Erik Lykke Mortensen

Context A number of studies suggest a positive association between breastfeeding and cognitive development in early and middle childhood. However, the only previous study that investigated the relationship between breastfeeding and intelligence in adults had several methodological shortcomings.Objective To determine the association between duration of infant breastfeeding and intelligence in young adulthood.Design, Setting, and Participants Prospective longitudinal birth cohort study conducted in a sample of 973 men and women and a sample of 2280 men, all of whom were born in Copenhagen, Denmark, between October 1959 and December 1961. The samples were divided into 5 categories based on duration of breastfeeding, as assessed by physician interview with mothers at a 1-year examination.Main Outcome Measures Intelligence, assessed using the Wechsler Adult Intelligence Scale (WAIS) at a mean age of 27.2 years in the mixed-sex sample and the Børge Priens Prøve (BPP) test at a mean age of 18.7 years in the all-male sample. Thirteen potential confounders were included as covariates: parental social status and education; single mother status; mother's height, age, and weight gain during pregnancy and cigarette consumption during the third trimester; number of pregnancies; estimated gestational age; birth weight; birth length; and indexes of pregnancy and delivery complications.Results Duration of breastfeeding was associated with significantly higher scores on the Verbal, Performance, and Full Scale WAIS IQs. With regression adjustment for potential confounding factors, the mean Full Scale WAIS IQs were 99.4, 101.7, 102.3, 106.0, and 104.0 for breastfeeding durations of less than 1 month, 2 to 3 months, 4 to 6 months, 7 to 9 months, and more than 9 months, respectively (P = .003 for overall F test). The corresponding mean scores on the BPP were 38.0, 39.2, 39.9, 40.1, and 40.1 (P = .01 for overall F test).Conclusion Independent of a wide range of possible confounding factors, a significant positive association between duration of breastfeeding and intelligence was observed in 2 independent samples of young adults, assessed with 2 different intelligence tests.

Are Adolescents Who Were Breast-fed Less Likely to Be Overweight?

Article

Mar 2005
EPIDEMIOLOGY

Background: Cohort analyses suggesting that breast-feeding protects against being overweight have been criticized for inadequately controlling for confounding associated with the self-selection of feeding practices. Methods: Using nationally representative U.S. data from the National Longitudinal Study of Adolescent Health (1994–1996), we performed traditional cohort analyses (n = 11,998) using logistic regression to estimate the relation between breast-feeding and adolescent overweight (body mass index ≥85 percentile, based on year 2000 CDC growth charts), controlling for known potential confounders. Breast-feeding also was assessed in a subsample of 850 sibling pairs to account for unmeasured genetic and environmental factors. Results: Among girls in the full cohort, the odds of being overweight declined among those who had been breast-fed at least 9 months; odds ratios ranged from 0.90 (95% confidence interval = 0.74–1.09) for <3 months of breast-feeding to 0.78 (0.64–0.96) for ≥9 months. A similar effect was seen in boys, although these trends were less consistent. In contrast, an analysis of sibling pairs provided no evidence of breast-feeding effects on weight within discordant trends. Conclusion: Cohort data indicate that odds of being overweight decrease as breast-feeding duration increases, at least among girls. However, sibling analyses suggest that this relationship may not be causal but rather attributable to unmeasured confounding related to mothers’ choice to breast-feed, or to other childhood risk factors for overweight. Our results illustrate the utility of sibling analyses in understanding the true effect of early life exposures (such as breast-feeding) on health outcomes over time, independent of confounding factors that may not be satisfactorily controlled using traditional prospective cohort methods.

A review of the breastfeeding literature relevant to osteopathic practice

Article

Jun 2011
INT J OSTEOPATH MED

Denise Cornall

Background: A review of the breastfeeding related literature was undertaken to provide background for a qualitative study that explores how osteopaths promote effective breastfeeding. Topics considered relevant to osteopathic practice are presented with the aim of informing and stimulating discussion and further inquiry. Data Sources and Selection: Information is drawn together from the following databases: Lactation Resource Centre of Australian Breastfeeding Association, Cinahl, Cochrane Library, and Medline. Qualitative and quantitative studies of all designs, government and professional association websites, and conference presentations are included as the aim is to generate a broad background on the biological and psychosocial aspects of breastfeeding that could impact on osteopathic practise. The theoretical literature is included in areas where little research is available. Conclusions: A strong evidence base promotes breastfeeding as important health behaviour for a mother and baby; influenced by many complex and sensitive biopsychosocial factors. The theoretical literature and studies that have investigated the biomechanics of breastfeeding provide a rationale for osteopathic treatment to facilitate effective breastfeeding; however little supportive research has been undertaken. Further well designed studies are needed to determine the role that osteopaths might play in supporting a mother-baby dyad to successfully breastfeed.

Association between parity and breastfeeding with maternal high blood pressure

Article

Feb 2013

Objective: The objective of this study was to determine how parity and breastfeeding were associated with maternal high blood pressure, and how age modifies this association. Study design: Baseline data for 74,785 women were sourced from the 45 and Up Study, Australia. These women were 45 years of age or older, had an intact uterus, and had not been diagnosed with high blood pressure before pregnancy. Odds ratios (ORs) and 99% confidence intervals (CIs) for the association between giving birth, breastfeeding, lifetime breastfeeding duration, and average breastfeeding per child with high blood pressure were estimated using logistic regression. Results: The combination of parity and breastfeeding was associated with lower odds of having high blood pressure (adjusted OR, 0.89; 99% CI, 0.82-0.97; P < .001), compared with nulliparous women, whereas there was no significant difference between mothers who did not breastfeed and nulliparous women (adjusted OR, 1.06; 99% CI, 0.95-1.18; P = .20). Women who breastfed for longer than 6 months in their lifetime, or greater than 3 months per child, on average, had significantly lower odds of having high blood pressure when compared with parous women who never breastfed. The odds were lower with longer breastfeeding durations and were no longer significant in the majority of women over the age of 64 years. Conclusion: Women should be encouraged to breastfeed for as long as possible and a woman's breastfeeding history should be taken into account when assessing her likelihood of high blood pressure in later life.

Breastfeeding Duration and Cognitive Development at 2 and 3 Years of Age in the EDEN Mother-Child Cohort

Article