Search Results (310)

This study aimed to compare cognitive, language, and motor development outcomes among children attending public and private Early Childcare Centers (ECCs), considering birth factors and family and daycare environments. Additionally, it examined the proximal and distal factors influencing children’s development. Cognitive, language, and motor skills were assessed in the children, along with evaluations of ECC quality, teacher practices, and knowledge of child development. Results indicated that children enrolled in public ECCs achieved higher scores in cognitive and language development, despite coming from families with lower socioeconomic status and having lower birth weights. They also benefited from longer periods of breastfeeding. Teachers in public ECCs demonstrated greater daily practices, providing enhanced movement opportunities for children. Private ECCs offered more suitable outdoor spaces, whereas public ECCs had better indoor spaces. Regression analysis revealed that daily practice, teachers’ experience, and the availability of gross motor toys explained 41% of the variance in motor development. The duration of breastfeeding explained 24% of the variance in cognitive development. Teachers’ knowledge about children’s development and attendance at public ECCs explained 31% of the variance in language development. These findings underscore the importance of prioritizing teacher education in both public and private ECCs to optimize children’s overall development. Full article

Breast milk is the optimal nutrition for infants, yet lactation insufficiency remains a common cause of early breastfeeding cessation. Moringa oleifera has been traditionally used as a galactagogue due to its rich micronutrient and phytosterol content. This systematic review assessed the effects of Moringa leaf supplementation on prolactin levels and breast milk volume in postpartum mothers with lactation insufficiency. A systematic search following PRISMA guidelines, was conducted for randomized controlled trials involving healthy postpartum women supplemented with Moringa oleifera. Risk of bias was evaluated using the Cochrane Risk of Bias Tool. Eight studies met the inclusion criteria, with intervention durations ranged from 3 to 10 days. Moringa supplementation increased significantly breast milk volume by up to 400 mL/day compared to controls. Serum prolactin levels also rose significantly with a mean increase of 231.72 ng/mL Most studies exhibited low to moderate risk of bias, though one study exhibited high risk due to lack of binding and subjective outcome measurement. Moringa oleifera leaf supplementation appears to enhance lactation by increasing milk volume and prolactin levels in postpartum mothers. However, further longer-term studies are needed to establish optimal dosing, sustained effectiveness, and safety. Full article

Background: Breastfeeding is essential for preventing non-communicable diseases. However, mothers with chronic illnesses tend to breastfeed less, increasing the likelihood of abandoning breastfeeding, especially if they experience gestational complications. Objective: To analyze the association between factors such as prepregnancy maternal characteristics, gestational complications, food security, barriers, and facilitators with the practice of exclusive breastfeeding. Methods: Cross-sectional study with 566 women who had prenatal care and gave birth at the National Institute of Perinatology (Mexico City) between 2021 and 2024. Surveys were administered on breastfeeding practices, food insecurity, barriers, and facilitators of exclusive breastfeeding in mothers. In addition, sociodemographic information, medical history (prepregnancy conditions and complications), gestational weight gain, and neonatal outcomes were recorded. Results: Of the 566 women, only 43.6% practiced exclusive breastfeeding, with a median duration of 4 months. Exclusive breastfeeding was more frequent in young, stay-at-home mothers with lower educational attainment and in those with food insecurity, who also tended to delay the introduction of complementary foods until after six months. Prepregnancy risk conditions (OR 1.56, 95% CI 1.06–2.30) and multiparity (OR 1.64, 95% CI 1.08–2.49) increased the risk of non-exclusive breastfeeding. Conversely, food insecurity (OR 0.40, 95% CI 0.20–0.78) and counseling from healthcare personnel (OR 0.09, 95% CI 0.01–0.51) showed a protective effect. The analysis also showed that paid employment (OR 4.68, 95% CI 1.65–13.21), the perception of low milk production (OR 6.45, 95% CI 2.95–14.10), maternal illness/medication (OR 3.91, 95% CI 1.36–11.28), and fatigue (OR 4.67, 95% CI 1.36–11.28) increased the probability of non-exclusive breastfeeding. Conclusions: In Mexico, the promotion of exclusive breastfeeding faces challenges, especially in mothers who begin pregnancy with significant chronic conditions such as diabetes, hypertension, obesity, advanced maternal age, and hypothyroidism, among others. Healthcare personnel should provide personalized advice to each woman from the prenatal stage on strategies to achieve and maintain exclusive breastfeeding. Full article

Background/Objectives: Worldwide, men experience a higher incidence of pancreatic cancer (PC) than women. Methods: To increase understanding of the underlying reasons for this sex-related difference, we analysed general and sex-related risk factors for PC in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort (women/men No. = 293,682/136,728; 717/577 PC-cases). Results: Cox proportional hazards models showed a 1.31-fold higher risk of developing PC for men compared to women (HR, 95% CI 1.15–1.49) after adjustment for age, smoking history, BMI, diabetes, and alcohol consumption. Associations of PC with established risk factors did not differ between men and women, with the exception of a greater risk of PC among women with greater attained body height, meat consumption and cigarettes smoked (1.12 (1.05–1.19) per 5 cm, 1.18 (1.02–1.36) per 100 g/d, 1.42 (1.27–1.59) per 10/d; respectively). Among child-bearing women, long cumulative duration of breastfeeding was inversely associated with risk of PC (HR 0.74, 95% CI 0.61–0.89) for >5.7 months of breastfeeding (median) relative to ≤5.7 months and among HRT users, cumulative duration of HRT use was inversely associated with PC risk (HR 0.71, 95% CI 0.53–0.95, >2.4 versus ≤2.4 years). Further reproductive and hormonal factors, such as age at menarche, number of full-term pregnancies, age at menopause, or use of oral contraceptives, were not significantly associated with PC risk. Conclusions: Pooled analyses of large cohort studies are needed to confirm these results, and detailed data on the type and intensity of HRT are required to better evaluate its effect. Full article

Background/Objectives: Despite high breastfeeding initiation rates nationwide, disparities in breastfeeding continuation among Black mothers remain a public health issue. The BreastFeed Iowa Black Immigrant Project aimed to improve breastfeeding rates among low-income Black immigrant mother-infant dyads in Johnson County, Iowa by exploring factors influencing breastfeeding retention and developing a framework for culturally sensitive breastfeeding interventions. Methods: Using a descriptive cross-sectional study design, we employed a convergent, parallel mixed-methods approach to explore factors that influence breastfeeding duration among Black immigrant mothers with children 0–2 years old. Nine focus group discussions (FGDs) were conducted on Zoom among 40 participants with a semi-structured guide on breastfeeding beliefs, experiences, and feeding practices. Additionally, a 22-item survey was administered to 33 participants. Results: Based on the survey, one out of five participants indicated that they were unable to breastfeed for as long as they had planned. The top five reasons why mothers stopped breastfeeding included having received formula from the Supplemental Nutrition Program for Women, Infants and Children; being sick and having to take medicine; the baby was hungry too often; the baby was sick and could not breastfeed; and not producing enough milk. The top five themes that emerged from FGDs as barriers to breastfeeding included lack of lactation support, knowledge gaps on breastfeeding benefits, perception of inadequate milk supply, lack of comfort with breast milk expression, and work-related barriers. Conclusions: The community needs assessment identified the elements needed to develop a culturally sensitive framework with targeted interventions to address breastfeeding barriers in the Black immigrant community. Full article

Background/Objectives: The transition to motherhood can be particularly challenging for women with limited socioeconomic resources or mental health concerns. The FAmily Clinic And Municipality (FACAM) intervention was designed to provide additional support through health visitors or family therapists, starting in pregnancy and continuing until the child reached school age. This paper evaluates the effects of the FACAM intervention on the secondary outcomes, maternal mental health and parental functioning during the child’s first year of life. Methods: A total of 331 pregnant women were randomized to either the FACAM intervention (n = 163) or usual care (n = 168). Participants completed questionnaires at baseline and at 3 (N = 284) and 12 (N = 248) months postpartum. Outcomes included maternal mental well-being, satisfaction with motherhood, depressive symptoms, parental stress, parental reflective functioning, worries, and breastfeeding duration. Results: At 12 months postpartum, FACAM mothers reported greater concern about housing issues (b = 0.56, 95% CI [0.06, 1.06], p = 0.03). No other significant differences in the reported outcomes were observed between the groups. Conclusion: The FACAM intervention did not demonstrate superiority over usual care in improving maternal mental health and parental functioning during the first year postpartum. The high-quality and needs-based approach of standard care in Denmark may have limited the potential for additional interventions to yield measurable improvements in maternal outcomes. Full article

Objectives: This study aimed to evaluate exclusive breastfeeding (EBF) rates and the duration of breastfeeding among mothers of twins and to identify the maternal, neonatal, and social factors associated with these outcomes. Methods: This retrospective cross-sectional study included 153 mothers of twin infants who were delivered at a tertiary hospital. Data were obtained from medical records and postnatal telephone interviews. Univariate analyses were performed to assess associations with EBF and breastfeeding duration, while multiple linear regression was performed to identify the independent predictors of breastfeeding. Results: The EBF rate within the first six months was 15%, and the mean breastfeeding duration was 10.5 ± 8.3 months. Tandem breastfeeding was positively associated with breastfeeding duration (β = 5.80; 95% CI: 3.51 to 8.10; p < 0.001), whereas bottle feeding showed a strong negative association (β = −9.49; 95% CI: −12.88 to −6.10; p < 0.001). Infants born before 34 weeks had significantly shorter breastfeeding durations, higher rates of NICU admission and respiratory support, and received less skin-to-skin contact and breastfeeding counselling compared to term infants (p < 0.05). Conclusions: Exclusive breastfeeding rates among mothers of twins remain low. Encouraging tandem breastfeeding, reducing bottle use, and providing tailored lactation support—particularly for mothers of preterm infants—may improve breastfeeding outcomes. Breastfeeding support should be adapted according to gestational age in neonatal care. Full article

Background/Objectives: Breastfeeding has been positively associated with development of various developmental and cognitive outcomes. Although not fully understood, psychosocial, environmental, nutrients (docosahexaenoic acid) etc., have been proposed as reasons. There is a paucity of studies that have looked at individual language milestones and language milestones associated with school readiness in the age group of 3–5 years old in a nationally representative sample. This study aimed to analyze the language milestones association with breastfeeding in this group of children. Methods: The dataset was obtained from the National Survey of Child Health (NSCH) 2022–2023 combined sample. Overall, 22,866 children met the inclusion criteria. Secondary analysis of the NCSCH data was done using multinomial regression models amongst four breastfeeding categories (never breastfed, breastfed less than 6 months, breastfed until 6 months but not exclusively, exclusive breastfeeding) with 16 language variables. Results: The results of the study show that children in the breastfeeding categories (breastfed until 6 months but not exclusively and exclusive breastfeeding until 6 months) had a positive association across many language variables including variables used to analyze school readiness. Individual language variables’ adjusted odds ratio and significance has been analyzed. The reference category was never breastfed. Conclusions: The study results support positive association of breastfeeding with language variables. Per our review, limited research has been reported where so many individual language variables have been analyzed in a nationally representative sample across four different breastfeeding categories. Full article

Background/Objectives: In the context of maternal mental health, this cross-sectional study investigates a moderated mediation model to explore how prenatal planning is associated with postpartum depression. Specifically, we examined whether planned pregnancy (X) is associated with fewer postpartum depression symptoms (Y) through greater positive affect (M), and whether the indirect association is moderated by breastfeeding duration (W). Methods: Data were collected from 117 postpartum mothers via self-report questionnaires that measured the degree of pregnancy planning, positive affect, postpartum depression symptoms, and breastfeeding duration. Bootstrap analyses were performed to assess the conditional indirect effects across two levels of breastfeeding duration. Results: The findings suggest an indirect association between pregnancy planning and postpartum depressive symptoms through positive affect, moderated by breastfeeding duration. This association was statistically significant only among mothers who breastfed for less than six months, indicating that the protective emotional effect of pregnancy planning may be more evident in this group. No significant indirect effects were observed in mothers who breastfed beyond this duration. Conclusions: These exploratory findings suggest that positive affect may be a pathway through which prenatal planning relates to maternal well-being, particularly in the context of breastfeeding practices. Given the cross-sectional design, causal inferences cannot be drawn. Future longitudinal research is needed to confirm these associations. Full article

Background/Objectives: Breastfeeding multiple birth infants (MBIs) poses unique challenges that require tailored support; however, research on these mothers’ experiences is limited. This study explored the breastfeeding journeys of Australian mothers of MBIs, highlighting barriers, facilitators, and support needs. Methods: Data were collected via an online survey (May–August 2024) and included quantitative data on breastfeeding initiation, duration, and challenges, as well as qualitative insights into mothers’ experiences. Thematic analysis was used to identify key themes, and statistical analyses were used to compare breastfeeding outcomes by parity. Results: While most mothers (87%) had an antenatal intention to breastfeed, they faced barriers such as latching difficulties (56%), inadequate milk supply (49%), and sore nipples (47%). Preterm births (58%) and neonatal unit admissions delayed the breastfeeding initiation. Most mothers (99%) used electric breast pumps to boost milk supply (68%) and enable expressed breast milk feeding by other caregivers (65% of mothers). While 72% were satisfied with hospital breastfeeding support and some mothers received excellent hands-on support, others felt neglected due to busy staff or conflicting advice. Mothers frequently reported that breastfeeding guidance was geared toward singletons, leaving them unprepared for the challenges of feeding multiples. Mothers’ suggestions for improving care included specialised guidance, better access to lactation support, and in-home practical support to alleviate the burden of feeding and expressing. Additionally, mothers reported that healthcare professionals should be trained to offer practical, non-judgemental support to help mothers navigate the elaborate challenges of breastfeeding MBIs. Conclusions: This study underscores the need for early postpartum support and tailored guidelines to enhance MBI breastfeeding outcomes and maternal-infant well-being. Full article

Gestational diabetes mellitus (GDM) leads to increased lifelong cardiometabolic risk in both mothers and their offspring. The identification of effective strategies to contain the future risk of type 2 diabetes (T2D) and cardiovascular disease (CVD) is of utmost importance to reduce the burden of the disease. Breastfeeding (BF) is effective in reducing short- and long-term child morbidity. In recent years, BF has emerged as a candidate low-cost intervention to prevent future cardiometabolic complications both in mothers and infants exposed to GDM. The aim of this review is to provide an overview of the evidence about the possible metabolic benefits of BF for both mothers with a history of GDM and their offspring. Increasing evidence supports the positive effects of exclusive BF over formula feeding (FF) or mixed feeding on glucose homeostasis and the lipid profile in women with previous GDM in the early postpartum period. Studies with a longer observation suggest clear benefits of intensive and longer BF on the risk of diabetes and prediabetes in mothers after adjustment for confounders. In regards to infants, in most studies, the intensity and duration of BF are positively associated with slower infant growth curves compared with FF, indicating that the positive effect of BF on growth trends might contrast the increased risk of obesity and metabolic diseases observed in infants exposed to GDM. Considering these findings, a global effort should be made to support BF practice to possibly reduce cardiometabolic morbidity after GDM. Full article

Background: Being breastfed, following a healthy diet and staying active during childhood shape health trajectories across the life course, promoting long-term well-being. Despite the growing immigrant child population in Portugal, evidence on these behaviours, particularly among preschool-aged children, remains limited. In this context, this study examines the associations between migrant status and breastfeeding patterns, fruit and vegetable consumption, and participation in sports among children living in the Lisbon Metropolitan Area. Methods: A cross-sectional study nested within a cross-sequential cohort was carried out in the Lisbon region between May 2022 and April 2024. Approximately 760 children (49.4% immigrants) born in 2018 and 2020 were enrolled in the study. Data were collected through a face-to-face interview with parents, using a structured questionnaire with information on socioeconomic variables, migration history, breastfeeding habits, and children’s diet (fruit and vegetable consumption) and physical activity. We used parametric and non-parametric tests to compare migrant and non-migrant children. To quantify factors associated with the main outcomes, we estimated a logistic regression model and calculated crude and adjusted odds ratios and their respective 95%CI. Results: Immigrant children were disproportionately represented in socioeconomically disadvantaged families. Breastfeeding initiation rates were higher among immigrant mothers (96.3% vs. 87.6%, p < 0.001). Additionally, immigrant mothers had a longer median duration of any breastfeeding (14 vs. 8 months, p < 0.001) and of exclusive breastfeeding (6 vs. 4 months, p < 0.001). Immigrant children had significantly lower odds of consuming three or more portions of fruit (aOR = 0.700; 95%CI: 0.511–0.959; p = 0.027) and two or more portions of vegetables per day (aOR = 0.489; 95%CI: 0.350–0.684; p < 0.001) compared with non-immigrant children. They were also twice as likely to not engage in sports (aOR = 2.185; 95%CI: 1.512–3.158; p < 0.001). Conclusions: Breastfeeding was better implemented in immigrant children. The findings highlight the need to address social determinants of health and the challenges faced by immigrant families in promoting a balanced diet and sports participation for their children. Multisectoral, culturally appropriate interventions that sustain and promote good breastfeeding practices, improve access to healthy food, and encourage sports are crucial to reducing health inequalities. Full article

Background: Exclusive breastfeeding (EB), feeding an infant solely breast milk, has been recommended worldwide due to its health benefits for infants and mothers. However, EB rates remain low, due to several socio-demographic, occupational, and cultural factors. Objectives: Our aim was to investigate the factors associated with EB amongst Arab mothers living in Israel, i.e., age, education, religiosity, employment status, and the number of children which impact breastfeeding practices. Methods: Data were collected through surveys from Arab mothers of different religious and geographical backgrounds. Results: The findings revealed that older maternal age, higher levels of religiosity, and an increased number of children were positively associated with EB. Employment reduced EB. Muslim mothers were more likely to combine breastfeeding with formula; Christian and Druze mothers showed higher EB rates. Geographical disparities were also noted. Conclusions: This study highlights the complex interplay of socio-demographic and cultural factors that impact breastfeeding practices amongst Arab mothers in Israel, with significant implications for policy development and maternal support programs. We underscore the importance of incorporating religious and cultural considerations into breastfeeding promotion strategies. Public health initiatives should target support for working mothers by advocating extended maternity leave and breastfeeding-friendly workplace policies. Furthermore, community-based interventions should engage family members in supporting breastfeeding mothers. Full article

Aim: Parents’ knowledge of oral health plays a key role in shaping their children’s habits and preventing early childhood caries, particularly through breastfeeding and nutrition. This study aimed to assess parents’ knowledge of how dietary habits affect both oral health and early childhood caries rates. Materials and methods: An online cross-sectional survey was conducted among 595 parents of children aged 3 to 6 years old using a self-structured questionnaire. Sociodemographic data, the children’s characteristics, breastfeeding practices, daily diet, the perceived effects of diet on orofacial health, and self-reported dental caries were recorded. The data were analyzed using descriptive statistics, chi-square tests, and regression models. Results: One-third of the children had dental caries (200/595). The prevalence of caries was significantly higher among children from rural areas (40.5%) compared to those from urban areas (31.1%) (p = 0.021) and in low-income families (72.7%) compared to middle-income (35.4%) and high-income (25.1%) families (p = 0.002). Breastfeeding duration, bottle feeding, and night feeding were not significantly associated with the occurrence of caries. Only 11.1% of parents recognized the role of extended breastfeeding on a child’s demand over one year in promoting the development of tooth decay. Better knowledge was observed among parents with university degrees, in healthcare workers, and in parents with lower incomes (p < 0.05). Conclusions: Dental caries was prevalent, especially among children from rural areas and low-income families. Although there is no direct correlation between the duration of breastfeeding and dental caries, parental awareness of the preventive benefits of breastfeeding remains low. Education for parents about breastfeeding and nutrition’s impact on oral health can have a substantial effect on preventing ECC. Educational efforts aimed at specific audiences are necessary to boost knowledge and advance preventive strategies. This study must recognize its limitations due to its dependence on self-reported caries data. Subsequent research must include clinical dental evaluations to achieve findings that are both dependable and factual. Full article

Prenatal and postnatal health guidance, along with women’s individual experiences, greatly influences mothers’ breastfeeding decisions and duration. To understand this better, a methodology combining quantitative and qualitative data is essential. Objective: To map the scientific production on the promotion, protection, and support of breastfeeding developed from mixed methods research. Method: A scoping review that followed the JBI and PRISMA-ScR methodology. The search was carried out in the following databases: Medline/PubMed, EMBASE, Cochrane, BVS, CINAHL, Web of Science, and BDTD. The guiding question was: Which studies on the promotion, protection, and support of breastfeeding were developed using mixed methods? The research took place from December 2023 to June 2024. Results: Of the 3569 studies found, 36 studies using mixed methods were included, with a prevalence of explanatory sequential approaches. Breastfeeding rates in the selected studies remain lower than global recommendations. The barriers to breastfeeding reported by mothers include biological; emotional; cultural; unfavorable social and hospital environment; difficulties in clinical management; lack of support from family, friends, health professionals, and employers; and skepticism about the benefits of breastfeeding. On the other hand, the main facilitators of breastfeeding reported were education and counseling during prenatal, childbirth, and postpartum periods; women’s intention to breastfeed; support from family, employer, spouse, and health professionals. Conclusions: The studies highlighted various issues related to breastfeeding rates, barriers, and facilitators across different contexts and cultures worldwide. The findings demonstrate that employing mixed methods enables a comprehensive and nuanced assessment of breastfeeding practices and the evaluation of relevant interventions. Full article