Search Results (103)

Background: The Baby-Friendly Hospital Initiative (BFHI) promotes, protects, and supports optimal breastfeeding through facility-based strategies. While prior studies have examined individual BFHI components in specific contexts, global evidence on its overall impact remains limited. This systematic review and meta-analysis aimed to evaluate the BFHI’s effectiveness in improving early initiation and exclusive breastfeeding practices worldwide. Methods: A comprehensive search was conducted in PubMed, Web of Science, Scopus, and Google for English-language studies. Eligible studies included randomized controlled trials (RCTs), cluster RCTs, and quasi-experimental designs assessing BFHI’s effect on breastfeeding outcomes. Random-effects meta-analysis models were used to estimate the pooled effects with 95% confidence intervals (CI). Heterogeneity was assessed using I² statistics and p-values. Study quality was appraised using the GRADE approach. Results: Thirty studies met the inclusion criteria. The BFHI was associated with increased early initiation of breastfeeding (pooled RR 1.43; 95% CI: 1.12–1.81; I² = 97.1%). Positive associations were also observed for exclusive breastfeeding at four months (RR 1.18, 95% CI: 1.08–1.29; I² = 61.7%) and at six months (RR 1.56, 95% CI: 1.14–2.14; I² = 82.8%). Substantial heterogeneity reflected variability in study design, BFHI implementation fidelity, and context. Conclusions: Our findings suggest that the BFHI is effective in improving breastfeeding practices globally. However, study variability and partial implementation may limit the generalizability of results. High-quality RCTs assessing full BFHI implementation are needed to strengthen evidence and guide global maternal–child health policy. Full article

Cervical cancer continues to be a major global public health problem, with 661,021 estimated new cases and 348,189 deaths reported in 2022. Approximately 53% of women in Jordan reported not being screened for CC in recent years. This study aimed to investigate the determinants associated with not being screened for CC amongst Jordanian women of child-bearing age. This was a cross-sectional study derived from the 2023 Jordanian Demographic Health Survey (JDHS) with 12,580 women aged 15–49 years. The study employed a non-informative Bayesian binary logistic regression approach to identify the factors that are associated with not being screened for CC. Results showed that the prevalence of not being screened for CC was 83.8% (95% CI: 83.3–84.3). The determinants identified in this study were women’s age group (OR = 0.46; 95% CI: 0.34–0.62), education level (OR = 0.56; 95% CI: 0.34–0.91), smoking status (OR = 0.75; 95% CI: 0.63–0.91), women’s nationality (OR = 4.30; 95% CI: 1.03–27.74), breastfeeding status (OR = 1.64; 95% CI: 1.31–2.07), wealth index (OR = 0.61; 95% CI: 0.53–0.71), self-reported health status (OR = 0.74; 95% CI: 0.64–0.87), marital status (OR = 1.45; 95% CI: 1.08–1.96), and HIV testing status (OR = 0.55; 95% CI: 0.40–0.75). The prevalence of not being screened for CC amongst Jordanian women of child-bearing age was found to be very high: a red flag for attention. There is a need for interventions such as community awareness campaigns and education programmes focusing on women younger than 25 years, especially women living in rural and underserved areas. Additionally, incorporating policy interventions into public health facilities and having easy accessibility to tools or screening tests may improve rates of CC screening, and thus reduce the prevalence of CC. Full article

Background/Objectives: The global prevalence of childhood obesity and overweight is steadily increasing, representing a pressing public health concern due to its persistence during adolescence and adulthood and its association with elevated morbidity and mortality risks. This cross-sectional study was designed to examine the potential association between overweight/obesity and the presence of depressive and anxiety symptoms in children aged 6 to 9 years. Methods: A total of 4098 children from various urban and rural regions in Greece were enrolled. Data was collected through maternal questionnaires capturing sociodemographic characteristics, perinatal outcomes, anthropometric measurements, breastfeeding practices, and physical activity levels. Children fulfilled the Children’s Depression Inventory (CDI) and the State-Trait Anxiety Inventory for Children—State form (STAIC-S) to evaluate symptoms of depression and anxiety, respectively. Results: Childhood overweight/obesity was independently and significantly associated with a more than two-fold increased likelihood of presenting depressive and anxiety symptoms. Childhood overweight/obesity was also significantly associated with maternal obesity, gestational weight gain, childbirth weight, mode of delivery, exclusive breastfeeding, and children’s physical activity. Conclusions: Overweight and obesity in children aged 6–9 years are significantly associated with an elevated risk of psychological distress, including depression and anxiety. These findings underscore the need for targeted public health policies and nutritional interventions aimed at promoting healthy lifestyle practices from early childhood. Educational efforts should also support new mothers in adopting and sustaining health-promoting behaviors to mitigate the long-term consequences of childhood obesity. Full article

Background: Effective prevention of SIDS/SUID requires a multidimensional approach. It is essential to provide targeted support for marginalized families, improve access to healthcare services, and implement policies aimed at reducing social and economic inequalities. The parallel effective way to reduce the risk of sudden unexpected infant death is through increased awareness of proper infant care. Despite the guidelines available in many countries, the risk of infant death from non-medical causes is still reported. The aim of the study was to assess awareness regarding an infant’s sleep environment and safe sleep practices among Polish caregivers. Methods: The survey was conducted among 451 mothers of infants under 18 months of age. The survey questionnaire was prepared, which consisted of single- and multiple-choice questions with closed and open answers assessing safe sleep practices. Results: Analysis of the survey responses showed that most mothers in the sample (88.9%) were aware that the supine position is the safest. According to the survey, 74.5% of respondents believed that infants should not sleep in the same bed as parents or siblings. In addition, 78.3% of those women stated that infants should sleep separately in their own bed. Despite this knowledge, almost 37.76% of female respondents still put their infants to sleep in their parents’ bed. As many as 98.4% of respondents knew that any items should not be placed in an infant’s crib. Despite this knowledge, a third of respondents still placed additional items in their baby’s crib. In the study 90.7% of women believed that breastfeeding should begin within the first hour after birth. Conclusions: Knowledge of safe sleep recommendations, including sleep environment, sleep position, and spatial organization, does not always translate into proper caregiving practices. Understanding caregivers’ motivations and how they perceive medical information is critical to effective prevention of infant sleep safety. Full article

Background/Objectives: Breastfeeding is widely recognized as the best way to feed infants and has numerous health benefits for both mothers and infants. However, despite its well-documented benefits, breastfeeding rates remain lower than recommended in many parts of the world. This systematic review examines factors that create barriers for mothers trying to breastfeed, covering studies published between 2003 and 2025. Methods: A total of 18 studies were included in this systematic review, selected from the following databases: PsycINFO, MEDLINE, Academic Search Complete, Communication and Mass Media Complete, ERIC, SocINDEX, and CINAHL. Studies were selected based on predefined inclusion criteria, focusing on peer-reviewed articles that examined factors influencing breastfeeding practices. Data extraction and quality assessment were performed independently by two reviewers using standardized tools. The review analyzed personal, cultural, economic, and health-related barriers. Results: The analysis revealed multiple barriers to breastfeeding, categorized into personal, sociocultural, economic, and healthcare-related factors. Common challenges included a lack of counseling, latching difficulties, insufficient workplace support, and cultural misconceptions. The heterogeneity of study designs posed challenges in synthesizing the findings. Conclusions: More targeted policies and programs are needed to address these barriers and help mothers succeed in breastfeeding. Improving breastfeeding outcomes worldwide will require better healthcare, social support, and an understanding of cultural influences. Full article

Background/Objectives: The number of children with overweight and obesity is gradually increasing worldwide. This is an emergent public health problem as overweight and obesity persist through the next stages of human life, being associated with high risk of morbidity and mortality. In this respect, the purpose of the current cross-sectional survey is to explore whether the overweight/obesity of children aged 6–9 years may be related to the risk of developing perceived stress and poor sleep quality symptoms. Methods: This study recruited 4350 primary school children from diverse Greek rural and urban regions. The mothers of the enrolled children completed relevant questionnaires on children and maternal sociodemographics, anthropometric parameters, perinatal outcomes, breastfeeding practices, and lifestyle factors. The enrolled mothers also completed the Perceived Stress Scale (PSS) and the Pittsburgh Sleep Quality Index (PSQI) to evaluate the perceived stress and sleep quality of their matched children, respectively. Results: Our analysis reveals independently significant associations between diverse factors and children’s overweight/obesity such as child’s gender, family economic status, maternal gestational weight gain, childbirth weight, kind of delivery, exclusive breastfeeding, and children physical activity. Childhood overweight and obesity were independently associated with a more than three-fold higher risk of perceived stress and a more than two-fold higher likelihood of poor sleep quality after adjustment for multiple confounding factors. Conclusions: Obesity and overweight are related to enhanced risk of perceived stress and poor sleep quality in children aged 6–9 years. Public policies and dietary counseling interventions should be applied to inform new mothers about the harmful effects of childhood overweight/obesity and to direct them to adopt healthy dietary practices for their children. Full article

Stunting is a major global health concern, particularly in low- and middle-income countries, due to its persistently high prevalence. It often originates from chronic malnutrition during the critical first 1000 days of life. Maternal and child nutrition are critical determinants of a child’s growth and development. This article aimed to explore the impact, causes, and evidence-based strategies to accelerate the reduction of stunting incidence worldwide. This review was undertaken with sources from PubMed, Scopus, Google Scholar, Science Direct, and MEDLINE from October 2024 to January 2025. This review was undertaken with sources from PubMed, Scopus, Google Scholar, Science Direct, and MEDLINE from October 2024 to January 2025 using the keyword “Stunting”, “Causes of stunting”, “Stunting Impact”, “Stunting Intervention”, and “Stunting Prevention”. The findings highlight the multifactorial causes of stunting, including maternal malnutrition, inadequate breastfeeding and complementary feeding, poor sanitation, and socioeconomic factors. Stunting is associated with impaired linear growth, cognitive deficits, gut dysbiosis, endocrine disruption, anemia, and increased risk of chronic diseases later in life. Addressing stunting demands multisectoral strategies focusing on maternal and child nutrition, infection prevention, improved WASH (Water, Sanitation, and Hygiene) practices, and socioeconomic support. The evidence presented may guide policy development and targeted interventions to prevent stunting and its long-term effects. 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

Background/Objectives: Breastfeeding is a cost-effective early child health intervention that has been identified as a protective factor against adverse child health outcomes. However, as estimated by previous epidemiological studies, the prevalence of breastfeeding in most countries around the world is below the recommended levels established by the World Health Organization. This study aims to assess the changes in suboptimal breastfeeding mortality, disability-adjusted life years (DALYs), and years lost to disabilities (YLDs) on a global, regional, and national level from 1990 to 2021. Methods: Data regarding suboptimal breastfeeding in children under 5 years of age from 1990 to 2021 were extracted from the Global Health Data Exchange query tool. Data from 204 countries and territories countries were classified into 5 regions based on the sociodemographic index (SDI) and 21 Global Burden of Disease (GBD) regions according to geographical contiguity. The average annual percentage change (AAPC) was calculated to assess changes in the trends of suboptimal breastfeeding DALYs, YLDs, and mortality in the past 30 years. Results: Countries with high–middle (AAPC = −0.94, 95% CI = −0.95 to −0.93) SDI scores had the greatest degree of improvement in both suboptimal breastfeeding mortality from 28,043.47 to 1128.24 and disease burden from 43,202.94 to 4428.47, while countries with high (AAPC = −0.83, 95% CI = −0.86 to −0.81) and low SDI (AAPC = −0.63, 95% CI = −0.71 to −0.55) scores showed the least improvement from 16,775.75 to 5930.56 and 49,522.23 to 32,881.08, respectively. Conclusions: Significant global improvements in suboptimal breastfeeding mortality and morbidity have occurred in the last 30 years. However, the extent of improvement differs significantly across nations, while some countries also showed no improvements or increased suboptimal breastfeeding mortality and disease burden. Nation-specific policies that account for cultural practices and economic conditions are required to target vulnerable mothers that are unable to achieve optimal breastfeeding. Full article

Background/Objectives: There is extensive evidence that breastfeeding saves lives, improves health, and provides value to the economy and societies worldwide. The Philippines and Viet Nam have progressive policies to enable breastfeeding, and breastfeeding rates in these countries have substantively improved. In the Philippines, exclusive breastfeeding under six months (EBF) increased from 35.9% (2008) to 60.1% (2021) and, in Viet Nam, in just over a decade, EBF has more than doubled, from 17.0% (2010) to 45.4% (2021). We aimed to use an evidence synthesis to consolidate learnings from policy support to enable breastfeeding in the Philippines and Viet Nam, to identify insights to improve future programming to improve breastfeeding practices in these two countries, and glean learnings that can potentially be adapted for similar contexts. Methods: This manuscript presents a qualitative evidence synthesis of seven purposively selected research articles from the Philippines and Viet Nam. Results: Since the 1960s, the Philippines and Viet Nam have notably improved policies protecting breastfeeding. Both countries have implemented legislation that is substantially aligned with the International Code of Marketing of Breast-milk Substitutes and subsequent World Health Assembly resolutions. Both countries have improved paid maternity leave provisions, with Viet Nam providing 6 months of paid leave, yet insufficient coverage to informal workers, and the Philippines providing 3.5 months of paid maternity leave while expanding maternity protection coverage to informal workers. From 2006–2021, breastfeeding rates increased in both countries alongside policy improvements yet barriers to implementation remain. Conclusions: Implementation research has documented policy progress and improved breastfeeding rates in the Philippines and Viet Nam. Our analysis offers valuable lessons potentially applicable beyond these contexts, emphasizing the need for addressing policy gaps and targeted cross-sectoral policy actions to enhance breastfeeding practices. Learnings from implementing national marketing restrictions of commercial milk formula and associated products and maternity protection policies in these countries could inform the implementation of newly developed regional standards together with supportive policies, facilitating the harmonization of regional regulatory environments. Full article

In the manufacture of infant formulas, from raw materials to the final product, the ingredients are subject to high temperatures which favor the formation of undesirable compounds, some of them from the Maillard reaction, such as 5-hydroxymethylfurfural (HMF) and acrylamide, and others from thermal processing, such as the compound 3-monochloro-1,2-propanoldiol (3-MCPD). Finally, there is also a risk that the product may be adulterated with undesirable components such as melamine and cyanuric acid. Due to the vulnerability of infants during the first stage of life, this review answers the main question: How much of these undesirable compounds are present in commercial infant formulas, and what do we know about them? Accordingly, the review is divided into three sections: (1) Maillard reaction products (HMF and acrylamide), (2) products contained in vegetable oils (3-MCPD), and (3) fraudulent and/or adulterant compounds (melamine and cyanuric acid). The objective is to report on the occurrence of HMF, acrylamide, 3-MCPD, melamine, and cyanuric acid in infant formulas in order to support more solid public health policies related to infant feeding. These undesirable compounds represent a risk to infants, possibly contributing to kidney and neurological damage and causing mutations that increase the development of childhood cancer. Therefore, it is necessary to promote breastfeeding and establish stricter controls, with scientific evidence on the effects of HMF, acrylamide, 3-MCPD, melamine, and cyanuric acid in infant formulas to reduce their short- and long-term effects on infants’ health. Full article

Background: The complementary food introduction and consumption guidelines for atopic dermatitis and food allergy prevention have evolved; however, their impact on infant feeding practices remains unclear. This study aimed to analyze complementary food diversity trends in infants, identify vulnerable infants with limited food diversity, and examine the trends in infants with or without vulnerable factors over time. Methods: This study analyzed infants aged 9–12 months who participated in the food diversity survey, conducted as part of the National Health Screening Program in Korea from 2009 to 2020. The complementary food items included grains, vegetables, fruits, eggs, fish, and meats. Infants consuming “six” and “less than six” complementary food items were categorized into high- and low-food-diversity groups, respectively. The study employed logistic regression models to examine the trends in food diversity and vulnerable factors with an assessment of the interaction effects. Results: This study included 3,425,301 participants (51.5% male) aged 11.3 months (standard deviation, 0.8). The high-food-diversity prevalence significantly increased over time, from 30.8% in 2009 to 52.9% in 2020 (p < 0.001). Vulnerable infants included those with preterm birth, low birth weight, non-breastfeeding status, high socioeconomic status, non-Seoul residence at birth, any perinatal conditions, hospitalization due to wheezing, atopic dermatitis and food allergies. The high-diversity proportion increased significantly over the study period across all vulnerable factors (p for interaction < 0.001). However, no significant interactions were observed between the study years and vulnerable factors, except for food allergy (β Coefficient, −0.0117, p for interaction = 0.004). Conclusions: The increasing trends in high-complementary-food-diversity proportions highlight the substantial progress over the study period. However, persistent disparities in vulnerable populations underline the importance of targeted interventions, including tailored nutritional education and policies, that promote equitable dietary practices during early life. Full article

Introduction: Breastfeeding plays a fundamental role in newborns’ and infants’ health. Breast milk’s protective power against malnutrition and its positive effect on neurological and physical development are well established and are reflected in the policy statements of all major pediatric health entities. However, breastfeeding also plays an important role in the prevention of so-called non-communicable diseases, such as obesity, hypertension, dyslipidemia, and autoimmune diseases. Methods: This narrative review aims to analyze the effect of breastfeeding and breast milk on the development of non-communicable diseases, with a special focus on weight excess, dyslipidemia, allergy, and gastrointestinal diseases. This narrative review was carried out through three steps: executing the search, examining abstracts and full texts, and analyzing results. To achieve this, the databases PubMed, EMBASE, Scopus, ScienceDirect, Web of Science, and Google Scholar were explored to collect and select publications from 1990 to 2024 to find pertinent studies in line with this review’s development. The search included randomized placebo-controlled trials, controlled clinical trials, double-blind, randomized controlled studies, and systematic reviews. A total of 104 manuscripts were ultimately included in the analysis. Results: Breastfeeding is associated with a decreased vulnerability to early viral infections or chronic inflammatory conditions during preschool years, a reduced incidence of weight excess, and likely lower cholesterol concentration, besides having a small protective effect against systolic blood hypertension. Conclusions: Pediatricians must promote breastfeeding, support the mother–infant dyad, and consider breast milk as a real “health voucher” that can last lifelong. However, further studies are needed to better define the extent and duration of breastfeeding’s protective power in this context. Full article

Background: Mothers and their newborns experiencing caesarean birth often receive delayed or interrupted skin-to-skin care (SSC) despite the intervention being well recognised as beneficial to both mother and baby, with no associated risk for increased morbidity or mortality. Maternal birth satisfaction is recognised as an indicator of quality maternity care; however, most of the research has focused on early intraoperative SSC initiation and breastfeeding outcomes. Objectives: To collate and synthesise evidence for maternal satisfaction of intraoperative and early postpartum SSC during and immediately following caesarean birth. To identify timelines of implementation, barriers, and facilitators of SSC. Methods: An integrative review was conducted guided by the 5-stage Wittemore and Knalf’s framework. Four electronic databases (CINAHL, Medline, PsycINFO, Web of Science) were searched. Key terms were ‘Caesarean birth’, ‘skin-to-skin care’, ‘maternal satisfaction’. Studies published from 2014 to 5 September 2024 in English language were included. A hand search of potential inclusion articles was also searched to undertake a comprehensive review. The JBI critical appraisal checklist was used to assess the quality of inclusion studies. Results: 17 studies met the selection criteria and were included in this review. Intraoperative and early SSC during caesarean birth is associated with positive maternal birth satisfaction and contributes to improved birth experience for mothers with no negative implications. Conclusions: Increased access to intraoperative SSC will likely contribute to increased maternal satisfaction and positive birthing experience. Compliance with policy recommendations regarding SSC may improve with access to a flow chart tool identifying expectations of women’s intraoperative and postoperative care for caesarean birth. Full article

Promoting child well-being and development requires a multidimensional approach, including the right to adequate food practices. Socially vulnerable children are more exposed to adverse experiences, such as inadequate food consumption due to poverty. In this context, home-visiting programs are an important strategy for nutritional and health care education to provide relevant guidelines. This study describes breastfeeding and food consumption of children aged 0 to 24 months assisted by the Happy Child Program (Programa Criança Feliz—PCF) and aimed to investigate their association with socioeconomic factors and adherence to the program. This is an observational study, with a cross-sectional design, carried out with children assisted by the PCF in the Federal District, Brazil. Multivariate analysis was performed to identify sociodemographic and income factors, and household visits characteristics associated with breastfeeding, dietary diversity, and the consumption of ultra-processed food. A total of 301 children were assessed, 51.16% of whom were female. In 58.99% of households, the reference person was the mother; 86.20% were unemployed, and 27.08% had a low education degree. About 62.65% of beneficiaries lived on up to USD 200.00 per month and the majority faced food insecurity. The child’s age, and the mother’s current work situation were independently associated with the current breastfeeding situation, especially higher among women who did not work (p = 0.015). The minimum dietary diversity among children over 6 months old was 62.21% and presented a positive association with adherence to the program (p = 0.005). On the other hand, the consumption of ultra-processed foods was 77.21% and was associated with a longer follow-up time within the program (p = 0.047). The associations observed revealed the need to integrate family food choices and nutritional education into public policies for early childhood. Full article