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Structural and Systemic Factors Impacting Infant Feeding Decisions and Practices

A special issue of Nutrients (ISSN 2072-6643). This special issue belongs to the section "Nutritional Epidemiology".

Deadline for manuscript submissions: closed (30 November 2023) | Viewed by 3935

Special Issue Editors


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Guest Editor
Department of Human Development Nursing Science, University of Illinois at Chicago, Chicago, IL, 60612, USA
Interests: mprovements in maternal and child health; nutritional status; infant development; pregnancy; human milk
Special Issues, Collections and Topics in MDPI journals

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Guest Editor
Department of Human Development Nursing Science, University of Illinois at Chicago, Chicago, IL 60612, USA
Interests: health disparities; health systems; health care management; social determinants of health

Special Issue Information

Dear Colleagues,

Infancy, the first 12 months of life, is a particulary important time period which lays the foundation for immediate and life-long health. During this time, infants are primarily consuming human milk or formula and are introduced to solid foods as a complementary form of nutrition. Adequate and quality nutrition is an essential human need, affecting all aspects of health, and the context in which feeding occurs (e.g., environment, presence of a caregiver, etc.) also plays a role in overall health. It is well-established that early and consistent human milk feeding is associated with improved health outcomes for the child. In addition, the methods by which complementary solid foods are introduced and offered (e.g., quality and variety of foods, timing of introduction, consistency of foods, etc.) can also impact health and well-being. Feeding decisions and practices concerning infants vary greatly across individuals and groups, and are based on a myriad of influences that are often rooted in structural and systemic factors outside of the individual’s control. We welcome articles that focus on the structural and systemic factors that impact feeding decisions and practices concerning infant and ultimately infant health. We seek articles that address infant feeding, infant nutrition, human milk or formula feeding and health related to socioeconomic status, racism, social injustices, structural violence, representation, inconsistent or biased professional recommendations, over-reliance on growth metrics alone, medical interventions, employment, parental paid leave, childcare environments, and access to supports and services.

Prof. Dr. Mary Dawn Koenig
Prof. Dr. Crystal L. Patil
Guest Editors

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Keywords

  • infant nutrition
  • breastfeeding
  • human milk
  • feeding methods
  • complimentary feeding
  • first solid foods
  • social determinants of health
  • structural racism

Published Papers (3 papers)

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Research

13 pages, 2281 KiB  
Article
Factors Associated with Provider Practices Related to Infant Feeding in Primary Care Settings: Results from a Pilot Survey
by Hope K. Lima, Meghan Ganio Molinari, Jessie B. Hoffman, Lisa Akers, Karin I. Evans and Ashley Licata
Nutrients 2024, 16(2), 179; https://doi.org/10.3390/nu16020179 - 5 Jan 2024
Viewed by 1194
Abstract
In 2020, only 25.6% of dyads in the US were exclusively breastfeeding at six months. Previous research has shown that breastfeeding continuation improves when patients receive both prenatal and postpartum support. Additionally, breastfeeding self-efficacy can be directly impacted by interactions with primary healthcare [...] Read more.
In 2020, only 25.6% of dyads in the US were exclusively breastfeeding at six months. Previous research has shown that breastfeeding continuation improves when patients receive both prenatal and postpartum support. Additionally, breastfeeding self-efficacy can be directly impacted by interactions with primary healthcare providers. To facilitate improved lactation support and positive interactions with providers related to infant feeding in the primary care setting, a 49-question survey was utilized to conduct a retrospective, cross-sectional study. Using multiple regression analysis, the researchers tested a model to determine if certain factors could predict patients receiving lactation education in the primary care setting. The full model was statistically significant and accounts for 81.8% of the variance (R2 = 0.818, F (7, 21) = 9.015, p < 0.001, CI = 0.728 to 0.910). Variables that contributed significantly to the model included provider age, provider years of experience in maternal-child health, population density of the practice, and average provider preparedness and comfort with lactation support and medical management. As the only modifiable predictor significantly contributing to the model, future research is necessary to develop educational interventions to improve provider preparedness and comfort with lactation support and medical management. Such interventions may significantly improve the frequency of lactation education in primary care settings. Full article
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11 pages, 541 KiB  
Article
In-Hospital Formula Feeding Hindered Exclusive Breastfeeding: Breastfeeding Self-Efficacy as a Mediating Factor
by Lu Liu, Yuju Wu, Xiannan Xian, Jieyuan Feng, Yuping Mao, Siva Balakrishnan, Ann M. Weber, Gary L. Darmstadt, Yunwei Chen, Sean Sylvia, Huan Zhou and Scott Rozelle
Nutrients 2023, 15(24), 5074; https://doi.org/10.3390/nu15245074 - 12 Dec 2023
Cited by 1 | Viewed by 1203
Abstract
Breastfeeding self-efficacy (BSE), defined as a mother’s confidence in her ability to breastfeed, has been confirmed to predict the uptake of exclusive breastfeeding (EBF). Early experiences during the birth hospital stay, especially in-hospital formula feeding (IHFF), can impact both EBF and maternal breastfeeding [...] Read more.
Breastfeeding self-efficacy (BSE), defined as a mother’s confidence in her ability to breastfeed, has been confirmed to predict the uptake of exclusive breastfeeding (EBF). Early experiences during the birth hospital stay, especially in-hospital formula feeding (IHFF), can impact both EBF and maternal breastfeeding confidence. Therefore, our objective was to examine the association between IHFF and EBF outcomes and investigate whether this association is influenced by BSE. The study included 778 infants from a larger cohort study conducted in 2021, with a one-year follow-up in rural areas of Sichuan Province, China. We used a causal mediation analysis to estimate the total effect (TE), natural direct (NDE), and nature indirect effects (NIE) using the paramed command in Stata. Causal mediation analyses revealed that IHFF was negatively associated with EBF (TE odds ratio = 0.47; 95% CI, 0.29 to 0.76); 28% of this association was mediated by BSE. In the subgroup analysis, there were no significant differences in the effects between parity subgroups, as well as between infant delivery subgroups. Our study found that IHFF hindered later EBF and that BSE mediated this association. Limiting the occurrence of in-hospital formula feeding or improving maternal breastfeeding self-efficacy is likely to improve exclusive breastfeeding outcomes. Full article
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11 pages, 464 KiB  
Article
Breastfeeding Self-Efficacy, Personal Well-Being and Related Factors in Pregnant Women Living in a District of Istanbul
by Mehmet Sait Değer, Mehmet Akif Sezerol and Zeynep Meva Altaş
Nutrients 2023, 15(21), 4541; https://doi.org/10.3390/nu15214541 - 26 Oct 2023
Viewed by 1197
Abstract
In this study, we examined breastfeeding self-efficacy levels, well-being and sociodemographic factors in pregnant women. The population of this descriptive study consisted of women with a pregnancy of 27 weeks or more in the Sultanbeyli district of Istanbul, Türkiye. A questionnaire was administered [...] Read more.
In this study, we examined breastfeeding self-efficacy levels, well-being and sociodemographic factors in pregnant women. The population of this descriptive study consisted of women with a pregnancy of 27 weeks or more in the Sultanbeyli district of Istanbul, Türkiye. A questionnaire was administered via telephone calls to pregnant women aged 18 years and older. The first part of the questionnaire included questions regarding breastfeeding history and sociodemographic information. The second part included the Prenatal Breastfeeding Self-Efficacy Scale, and the last part included the Personal Well-Being Scale. Higher scale scores indicate higher levels of self-efficacy and well-being. In total, 385 women participated in the study. The median age of the pregnant women was 28.0 years (18.0–43.0). The median gestational week was 33.0 (27.0–42.0). Among women who had received breastfeeding counseling, those with a higher level of knowledge about breastfeeding had higher breastfeeding self-efficacy (p < 0.05). Women with better economic status also had higher well-being scores (p < 0.05). There was a positive correlation between well-being and breastfeeding self-efficacy approaching the statistical significance level (p = 0.052). It is important to consider factors that may be associated with women’s well-being and self-efficacy. Full article
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