Dear Colleagues,

Breastfeeding is a key public health strategy to improve the health of mothers and their infants. It is the best source of nutrition for most infants and reduces the risk for some short- and long-term health conditions for both infants and mothers. Clinicians, public health advisors, nutritionists, and others have been attempting to increase breastfeeding rates for the last few decades, with varying degrees of success. We need social science researchers to help us understand the role of infant feeding in the family.

While breastfeeding rates are increasing in all racial/ethnic populations, disparities in breastfeeding continue, with the lowest rates of breastfeeding being reported among African American and Native American mothers/infants. Low rates of breastfeeding add more than $3 billion a year to medical costs for women and children in the United States. Actions are needed with a focus on health equity and decreasing disparities in breastfeeding, primarily among African American and Native American families.

This Special Issue will present original articles, systematic reviews, meta-analysis, and case reports on breastfeeding. Original articles may discuss community interventions in improving barriers of breastfeeding, community-based participatory research (CBPR), theory of planned behavior, current and novel public health emergencies that threaten the support system for breastfeeding, social and ecological studies, and epidemiological studies on health benefits of breastfeeding and health risks of lack of breastfeeding. Case studies may address maternity care practices, lactation accommodation at worksites, baby-friendly initiatives, and impact of policies supporting breastfeeding.  

Prof. Dr. Amal Mitra
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

• Health effects
• Vulnerable population
• Disparities
• Health inequalities
• Interventions
• CBPR
• Policy issues
• Barriers
• Nutrition
• Growth
• Maternal health
• Child health
• Social theory
• Baby Friendly Hospitals
• Minority population

Title: Relationship between self-efficacy, acculturation, and breastfeeding behaviors among african-american women living in mississippi
Authors: Pamela A. Scott; Mohammad Shahbazi
Affiliation: Jackson State University College of Health Sciences, Jackson, MS 39213
Abstract: Background: According to the literature, African American women breastfeed at a significantly lower rate than other racial groups. Breastfeeding rates are particularly low in the South, with Mississippi having the lowest breastfeeding rates in the United States. Methods: To determine if there exists a significant relationship between culture and breastfeeding rates, a sample of 103 African American women were recruited from WIC programs throughout the state of Mississippi. The African American Acculturation Scale (revised) was used to measure acculturation, the Breastfeeding Self-Efficacy Scale SF was used to measure self-efficacy as it relates to breastfeeding, and the questionnaire included a survey developed by the researcher with specific questions about the breastfeeding behaviors: initiation, exclusivity, and duration. Pearson’s correlation was used to explore the relationship between the three variables: 1) Breastfeeding Self-Efficacy, 2) African American Acculturation, and 3) Breastfeeding Behaviors. Results: There were significant relationships between breastfeeding self-efficacy and breastfeeding behaviors in this sample. However, African American acculturation was only correlated with exclusive breastfeeding behavior. Conclusions: The results of this study raise concerns and suggest that socially disadvantaged African American women should be targeted for the breastfeeding promotion programs.

Title: Marketing of Breast Milk Substitutes in South African parenting magazines: How marketing regulations may be working
Authors: Sara Nieuwoudt, Linda Richter and Sukoluhle Pilime
Affiliation: University of the Witwatersrand, Johannesburg, South Africa
Abstract: Background: Despite evidence that exclusive breastfeeding (EBF) for the first six months is optimal for child health, EBF remains low globally. The formula industry has been implicated in undermining breastfeeding through the marketing of breastmilk substitutes (BMS). In response, countries struggling with low breastfeeding rates have introduced regulations to limit the marketing of BMS. In 2012 South Africa introduced Regulation 991, which prohibited marketing BMS products for infants below 6 months. Our main study aim was to explore if and how BMS products were presented in popular South African parenting magazines following R991. Specifically, we were interested in how BMS was framed in relation to issues faced by parents of newborns known to influence infant feeding choices, such as crying and sleeping. Methods: We applied a cross-sectional media content analysis design. All (18) print issues of two popular parenting magazines from 2018 were included. Coders used an a priori design, with two coding systems (one for text and another for images) for consistency. All issues were coded by two independent coders, with a third coder used for quality checks. Final codes had an intercoder reliability 0.80 or above. These codes were analysed descriptively. Additional qualitative textual analysis was conducted on a sub-set of texts purposively selected for their 1) representativeness, 2) disconfirming examples, and 3) exceptional examples. Results: Overall, no overt marketing of BMS to infants below 6 months was identified. However, the placement of a BMS advertisement next to another articles about young infants raised concerns about inference. Similarly, the use of vague wording and imagery in relation to common issues, such as sleeping and crying, was a potential avenue being used by BMS companies to draw attention to their products without flagrant violation of R991. Breastfeeding promotion was present in both magazines. Conclusions: In contrast to the aggressive marketing of BMS in parenting magazines in countries without clear regulations, BMS companies in South Africa seem to be abiding by R911. However, their subtle influence was still present and monitoring of print media is still advisable. This study did not explore other channels where BMS companies may have refocused marketing efforts, such as social media. Other countries considering stronger regulations of BMS advertising may be interested in this study as an example of how regulations may be influencing BMS marketing strategies.

Title: Low and decreasing trend in the practice of breastfeeding in Lahore, Pakistan
Authors: Safeena Amjad ^a; Shazia Ashraf ^a1; Hamid Jan Bin Jan Mohamed ^b,*; Soo Kah Leng ^b1; Nabeela Rashid ^c; Rimsha Fatima ^c1
Affiliation: a School of Health Sciences, Universiti Sains Malaysia, Lecturer/Dietitian, Department of Nutrition & Health Promotion, University of Home Economics Lahore, Pakistan; a1 School of Health Sciences, Universiti Sains Malaysia, Assistant Professor, Fatima Memorial Hospital, NUR International University, Lahore, Pakistan; b Professor, School of Health Sciences, Universiti Sains Malaysia; b1 Senior Lecturer, School of Health Sciences, Universiti Sains Malaysia; c Associate Professor, Head of Department of Pediatrics and Neonates, Punjab Medical Centre Lahore, Pakistan; c1 Demonstrator, Department of Nutritional Sciences, Institute of Allied Health Sciences, FMH College of Medicine & Dentistry Lahore Pakistan
Abstract: Pakistan is a low-middle income country where infant and child mortality rates are high. Breastfeeding offers a wide range of psychological and physical health benefits in the long term and short term for young children, infants, and mothers. The World Health Organization (WHO) recommends exclusive breastfeeding during the first six months of life for optimal growth, development and health. Breastfeeding should continue up to two years or more and nutritionally adequate, safe, and appropriately fed complementary foods should be introduced at the age of six months to meet the evolving needs of the growing infant. The current Lahore birth cohort study aimed to determine the frequency of mothers having exclusive breast feeding practices and finding various factors which may affect trends of exclusive breast feeding practices,. The study used information on the first 9 months of life of 200 children born from August 2019 to January 2022. All women who gave birth during this period were interviewed using questionnaire on breastfeeding and complementary feeding practices at recruitment and again twice, at 2.5 months age and at the age of 9 months. Women of age 18 to 45 years, working and non-working were included. The data were collected using an interview method by a pre-structured questionnaire. Data was analyzed using SPSS, version 28. Post stratification Chi square test was applied and P-value of

Title: Disparities in Infant Nutrition: WIC participation and Rates of Breastfeeding in Florida
Authors: Sarah G. Buxbaum; Olumide Arigbede; Arlesia Mathis; Fran Close; Sandra G. Suther; Elizabeth Mazzio; Remelda Saunders-Jones; Karam F.A. Soliman; Selina Darling-Reed
Affiliation: College of Pharmacy and Pharmaceutical Sciences, Institute of Public Health, Florida A & M University

Abstract: Being cognizant of the pronounced health advantages of breastfeeding for both the nursing mother and her infant, the breastfeeding dyad, we examined breastfeeding rates among Black and White Floridian women who gave birth from 2012 to 2014 (N = 639,052). We investigated the associations between breastfeeding initiation, WIC-based breastfeeding support (The Special Supplemental Nutrition Program for Women, Infants, and Children), education level, and race and ethnicity. We compared the percentage of breastfeeding mothers between those in the WIC program versus those who were not, and compared breastfeeding rates across racial and ethnic groups. Consistent with previous reports, Black newborns in this study were breastfed at lower rates than other racial groups. However, by breaking down the data by education level and race and ethnicity, we see a significant increased rate of breastfeeding due to WIC participation for both Hispanic and Black women with less than a high school education. Further, we assessed differences by insurance type, race and WIC participation. We also note a general trend of increasing rates of breastfeeding over the study period, which has positive public health implications.