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To estimate the effect of early, regular breast-milk pumping on time to breast-milk feeding (BMF) and exclusive BMF cessation, for working and non-working women.
Using the Infant Feeding Practices Survey II (IFPS II), we estimated weighted hazard ratios (HR) for the effect of regular pumping (participant defined) compared with non-regular/not pumping, reported at month 2, on both time to BMF cessation (to 12 months) and time to exclusive BMF cessation (to 6 months), using inverse probability weights to control confounding.
BMF (n 1624) and exclusively BMF (n 971) IFPS II participants at month 2.
The weighted HR for time to BMF cessation was 1·62 (95 % CI 1·47, 1·78) and for time to exclusive BMF cessation was 1·14 (95 % CI 1·03, 1·25). Among non-working women, the weighted HR for time to BMF cessation was 2·05 (95 % CI 1·84, 2·28) and for time to exclusive BMF cessation was 1·10 (95 % CI 0·98, 1·22). Among working women, the weighted HR for time to BMF cessation was 0·90 (95 % CI 0·75, 1·07) and for time to exclusive BMF cessation was 1·14 (95 % CI 0·96, 1·36).
Overall, regular pumpers were more likely to stop BMF and exclusive BMF than non-regular/non-pumpers. Non-working regular pumpers were more likely than non-regular/non-pumpers to stop BMF. There was no effect among working women. Early, regular pumpers may need specialized support to maintain BMF.
This chapter presents the national public health policies and programs related to helping women to conceive at a healthy weight, gain weight appropriately during pregnancy, and limit weight retention postpartum. Guidance on implementing weight gain guidelines was developed for prenatal care providers after the release of the 1990 Gestational Weight Gain (GWG) Guidelines. The policy framework for healthy weight gain during pregnancy exists and is supported by both expert committee reports and practice guidelines in the US. A postpartum visit was less likely among women with lower use of or access to health care. The Institute of Medicine/National Research Council (IOM/NRC) committee that recently revised the guidelines for GWG made recommendations that, if fully implemented, would represent a radical change in care offered to women of childbearing age, potentially leading to a reduction in obesity among women of childbearing age.
Despite a strong relationship between household food security and the health and nutritional status of adults and older children, the association of household food security with the growth of infants and young children has not been adequately studied, particularly in developing countries. We examined the association between household food security and subsequent growth of infants and young children in rural Bangladesh.
We followed 1343 children from birth to 24 months of age who were born in the Maternal and Infant Nutrition Intervention in Matlab (MINIMat) study in rural Bangladesh. A food security scale was created from data collected on household food security from the mothers during pregnancy. Data on weight and length were collected monthly in the first year and quarterly in the second year of life. Anthropometric indices were calculated relative to the 2006 WHO child growth standards. Growth trajectories were modelled using multilevel models for change controlling for possible confounders.
Household food security was associated (P < 0·05) with greater subsequent weight and length gain in this cohort. Attained weight, length and anthropometric indices from birth to 24 months were higher (P < 0·001) among those who were in food-secure households. Proportions of underweight and stunting were significantly (P < 0·05) lower in food-secure households.
These results suggest that household food security is a determinant of child growth in rural Bangladesh, and that it may be necessary to ensure food security of these poor rural households to prevent highly prevalent undernutrition in this population and in similar settings elsewhere in the world.