Breast-feeding in Egypt

Planning, implementation and evaluation of programmes to promote appropriate infant feeding practices require detailed, current information about these practices in the target populations. To estimate the prevalences and identify the correlates of overall breast-feeding and of exclusive breast-feeding in different age periods during infancy, a cohort of 152 apparently healthy neonates and their mothers were followed during October 1987 through April 1989 in rural Bilbeis, Sharqiya Governorate, Egypt. Feeding data were collected through twice weekly home visits thus reducing the potential for bias in our findings due to respondent recall errors. The prevalence of overall breastfeeding in the infants declined from 100% in age period 0-11 weeks to 89% in age period 36-47 weeks. Mothers with previous living children were associated with significantly higher (odds ratio [OR]: 6.53, 95% confidence interval [CI]: 1.33-32.09) and ownership of refrigerators was associated with significantly lower (OR: 0.18, 95% CI: 0.05-0.67) overall breast-feeding prevalences in age periods 24-35 and 36-47 weeks, respectively. The prevalence of exclusive breast-feeding in breast-fed infants dropped from 20% in age period 0-11 weeks to 0% in age period 36-47 weeks. After multivariate adjustment, prelacteal feeding was significantly negatively (OR: 0.12, 95% CI: 0.04-0.37) associated with exclusive breast-feeding in age period 0-11 weeks. Nearly 90% of Bilbeis infants were breast-fed at age 47 weeks, but the initiation of supplementation at 0-11 weeks in 80% of breast-fed infants is contrary to current recommendations.(ABSTRACT TRUNCATED AT 250 WORDS)     

The role of nitric oxide in mechanisms of the nephrotoxic effect of verografin

A clinic based cross-sectional study was conducted at Immunoprophylaxis Clinic at Govt. Medical College, Nagpur. Mothers of 217 children were interviewed for infant feeding practices. In 62.67% of children, breast-feeding was initiated within 24 hrs. after birth. About 22% mother used prelacteal feed and 70% mothers preferred demand feeding. Prominent area of concern includes discarding of colostrum, low exclusive breast feeding rate, delayed weaning and early termination of breast feeding. Further improvement in present day infant feeding practices is possible by emphasising on the health education component of existing nutritional programmes.     

Infant feeding and weaning practices in some semi-arid rural areas of Rajasthan

The paper contains information on infant feeding and weaning practices in the rural communities of a semi-arid district of Rajasthan. The findings have been drawn from a recent survey of 328 rural mothers. The rural women of this area are found to believe in old deep seated beliefs and customs, which in turn deprive their infants from advantages of colostrum (77% discarded colostrum) and nutritionally rich supplements, which otherwise should be supplemented to them at any cost in order to keep them healthy. The practices of prolonged breast feeding and delayed supplementation to infants are rampant in this area. Mean age at weaning (27.1 months) again not only affects the health status of mothers and their children but also leads to the undernutrition among both. The findings of the study necessitate to evolve an exhaustive educative programme dealing with various aspects of infant feeding and weaning practices, keeping in view their traditions, so that the useful practices can be encouraged and harmful ones be prohibited.     

Ontogeny of foraging behavior in wild vervet monkeys (Cercopithecus aethiops): Social interactions and survival.

The ontogeny of feeding behavior was explored by making observations of 32 vervet monkey infants in Amboseli National Park, Kenya. In contrast to adults and juveniles, infants appear to treat all primary food products in their diet as equally valuable. These age-related differences may reflect differences in food preference. To assess social influences, feeding synchrony between mother and infant was explored. From birth to 2 mo, infants typically fed asynchronously with respect to their mother's feeding bouts. From 2–22 mo, however, most infants fed at the same time and on the same food items as their mothers. Among infants there was a significant positive association between the proportion of synchronous, same food bouts and the probability of survival. Variation among infants in access to resources and encounter rates with predators did not, however, have a significant effect on survival. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A theory of planned behavior-based structural model for breast-feeding

BACKGROUND: Breast-feeding is the recommended method of infant feeding because it is clearly associated with health benefits for infants and their mothers. Yet, many women who initiate breast-feeding fail to meet their own personal goals or recommended standards for duration of breast-feeding. OBJECTIVE: To refine a Theory of Planned Behavior (TPB)-based structural model for explaining variability in breast-feeding intention and duration. METHOD: The study design was prospective, multicorrelational, and longitudinal. Out of the total sample of 635 women, 602 mothers of healthy, full-term infants provided complete datasets over the entire course of their breast-feeding experience and these datasets were used in the modeling analyses. Simultaneous multisample analysis of covariance structures was used to develop the model. RESULTS: The resulting TPB for Breast-Feeding (TPB-BrF) describes the rational, motivational processes of the original TPB, but reconfigures the relationships among them, for homemakers (TPB-BrF/H), women employed half-time or less (TPB-BrF/EL), and women employed more than half-time (TPB-BrF/EM). Mothers' early postpartum ratings of adequacy of milk supply and stimulus conditions of maternal education and breast-feeding knowledge were included in the TPB-BrF to better explain breast-feeding outcomes. Model complexity increased with employment effort. CONCLUSION: The TPB-BrF is a comprehensive, theoretically based, empirically verified model that can serve as a useful heuristic for understanding the personal motivational components of breast-feeding behavior.     

Physiologic effects of maternal smoking on breast-feeding infants

Women who smoke and breast-feed pose an unknown threat to their infants' health. In this pilot study, relationships between ingestion of nicotine in breast milk and physiologic effects in the infant were investigated. Infant physiologic effects measured were temperature, pulse, respiration, systolic blood pressure, and oxygen saturation. Five smoking and five nonsmoking mother-infant pairs were studied. Breast milk was analyzed for nicotine using gas chromatography. Breast milk from smoking mothers contained a mean of 33.1 ng/mL of nicotine while the breast milk from nonsmoking mothers contained a mean of less than 6.45 ng/mL of nicotine. Infant physiologic measures were taken before and 20 min after breast-feeding. After breast-feeding, infants of smoking mothers had a significant change in respirations and oxygen saturation while infants of nonsmoking mothers had a significant change in pulse only. Results provide a scientific basis for counseling smoking, breast-feeding mothers.     

Childrearing and impulse control in toddlers: A naturalistic investigation.

Observed 18 firstborn toddlers (aged 12–15 mo) and their mothers in their homes on 2 occasions (1 wk apart) for 45 min on each day. Childrearing practices were assessed through interviews and naturalistic observations; impulse control, defined as the nonmanipulation of breakable or dangerous objects, was assessed by describing the objects that infants manipulated. Findings reveal that mothers made numerous demands on their infants for impulse control and enforced them promptly and consistently. Mothers who relied on physical punishment had infants who were more likely to ignore maternal prohibitions, to manipulate breakable objects, and to show low levels of nonverbal competence 7 mo later. Physically punishing mothers made the fewest objects available in their homes for infant manipulation. Implications of these findings for the development of early impulse control and cognitive functioning are considered. Results show that individual differences in impulse control during this time period are related to individual differences in disciplinary style, which are related to characteristics of the physical environment, compliance to maternal demands, and infant performance on standardized intelligence tests. Findings illustrate the importance of a multimethod approach to developing impulse controls. (21 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Maternal feeding practices and childhood obesity: a focus group study of low-income mothers

OBJECTIVE: To identify maternal beliefs and practices about child feeding that are associated with the development of childhood obesity. DESIGN: Four focus groups. One group of dietitians from the Supplemental Nutrition Program for Women, Infants, and Children (WIC) in the Northern Kentucky Health District and 3 groups of mothers with children enrolled in WIC. SETTING: The WIC program in the Northern Kentucky Health District. PARTICIPANTS: Fifteen WIC dietitians and 14 mothers (14 to 34 years of age) with young children (12 to 36 months of age) enrolled in WIC. RESULTS: The mothers in this study (1) believed that it was better to have a heavy infant because infant weight was the best marker of child health and successful parenting, (2) feared that their infants were not getting enough to eat, which led them to introduce rice cereal and other solid food to the diets before the recommended ages, and (3) used food to shape their children's behaviors (eg, to reward good behavior or to calm fussiness). The mothers acknowledged that some of their child-feeding practices went against the advice of their WIC nutritionists and physicians. Instead, the participants relied on their mothers as their main source of information about child feeding. CONCLUSIONS: Physicians and allied health professionals discussing childhood growth with mothers should avoid implying that infant weight is necessarily a measure of child health or parental competence. Parents who use food to satisfy their children's emotional needs or to promote good behavior in their children may promote obesity by interfering with their children's ability to regulate their own food intake. Interventions to alter child-feeding practices should include education of grandmothers.     

Infant feeding practices in St. Vincent and factors which affect them

A survey was conducted in the summer of 1975 in 2 towns in St. Vincent--Layou and Georgetown--in the effort to obtain information regarding infant feeding practices and some of the factors which may influence them. Mothers of children from 1-2 years of age were interviewed in their homes. Complete data sets were obtained on 192 of the 216 eligible children in the 2 towns. For most children the period of exclusive breastfeeding (no other milk product given) was very short. About 1/2 of the children had received milk by 2 weeks of age, and 75% by 1 month. This was followed by a much longer period of "mixed" feeding--both breast and bottle--until breastfeeding was stopped at a median age of 6.8 months. Many types of milk were used for infant feeding. For 73% of the infants, infant formula was the 1st type of milk given. This was commonly replaced by a "heavier" full cream powdered milk at a few months of age. Prelacteal feeds were very common, predominantly glucose water. "Tonics," often consisting of vitamin preparations, were another common supplement during the early months of life. Among solid foods, arrowroot, "custard," and commercial infant cereals were the first to be introduced. Relatively inexpensive locally bagged staple foods and milk powders were available in both towns, but most mothers relied heavily on packaged brand name products for infant feeding even though the cost was 2-10 times higher. It was not possible to pinpoint the exact causes for the high levels of bottle feeding, nor for the possible recent decline in breastfeeding, but several important factors were identified. Part of the problem appeared to be due to poor health and nutritional status of the mothers. In addition, in several cases the mothers reported that they had wanted to continue breastfeeding but had received no support from health professionals, and in a few instances had been ordered to stop for seemingly trivial medical reasons.     

Prediction of infant-father and infant-mother attachment.

The 1st-yr correlations of infant–father and infant–mother attachment were investigated in a longitudinal study of early family development. Mothers and fathers were observed interacting with their 1st-born, 3-mo-old infants. Parents also were interviewed individually at 3 mo child age concerning their time with the infant and their attitudes and reports about the infant and their parental role. Mothers and fathers were seen in the strange situation with their infant at 12 mo. For infants and fathers, security of attachment was predicted from the qualities of interaction at 3 mo, the father's attitudes and reports about the infant and the paternal role, and the father's time with the infant. For infants and mothers, security of attachment was predicted from the qualities of interaction at 3 mo and the mother's time with the infant. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Sleeping position, orientation, and proximity in bedsharing infants and mothers

The impact of mother-infant bedsharing on infant sleeping position, orientation, and proximity to the mother was assessed in 12 breast-feeding Latino mother-infant pairs. Six routinely bedsharing and six routinely solitary-sleeping pairs slept 3 nights in the sleep laboratory. The first night matched the routine home condition, followed by 1 bedsharing night and 1 solitary-sleeping night in random order. During bedsharing infants were never placed prone, regardless of their routine sleeping condition. On the bedsharing night, mothers and infants spent most of the night oriented toward each other; seven of 12 infants remained oriented toward their mothers the entire night. While sleeping in a face-to-face orientation, most pairs slept most of the time less than 30 cm apart with appreciable amounts of time at less than 20 cm. This orientation and proximity should facilitate sensory exchanges between mother and infant which, we hypothesize, influence the infant's sleep physiology and nocturnal behavior. We conclude that bedsharing minimizes the use of the prone infant sleeping position, probably in part to facilitate breast feeding. By promoting nonprone positions, bedsharing may protect some infants from sudden infant death syndrome (SIDS), since prone sleeping is a known risk factor for SIDS. The large percentage of the night that mothers spent oriented toward their infants suggests that a higher degree of maternal vigilance may also result from bedsharing.     

The balance of employment and motherhood: Longitudinal study of mothers' feelings about separation from their first-born infants.

Examined how older, college-educated White mothers' preference to be employed or to remain home with their infants affected the development of their anxiety about separation from their infants over the 1st 13? mo of motherhood. On measures of anxiety about separation, career salience, and maternal role investment, 26 mothers (mean age 27.38 yrs) who preferred employment were compared with 36 mothers (mean age 27.89 yrs) who preferred to stay at home. Measures were taken at 2 days, 7 wks, 8 mo, and 13? mo postpartum. Employment-preference mothers' anxiety about separation declined earlier and to a greater extent than that of home-preference mothers, who were more strongly invested in the maternal role but less committed to jobs or careers. Discussion centers on the importance of employment preference as opposed to actual employment status for understanding how women balance career and motherhood. (21 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Longitudinal observation of infant temperament.

Convergent validity, temporal stability, and age-related patterning of measures of infant temperament were examined in a longitudinal study of 46 infants at 3, 6, and 9 mo of age. At each age, mothers completed the Infant Behavior Questionnaire (IBQ), and the behavior of infants and their mothers was observed at home and during bath, feeding, and play. Temperamental dimensions of activity level, smiling and laughter, distress to limitations, fear, and vocal activity were investigated. Findings show that the IBQ and home observations, corrected for attenuation, showed convergent validity for all 5 temperament scales at 3 mo and for 4 of 5 scales at both 6 and 9 mo of age. Composite measures of positive and negative reactivity and overall reactivity showed significant convergence at all ages, with the exception of the positive composite at 3 mo of age. Relative stability of positive reactivity was found across both 3- and 6-mo intervals, whereas negative reactivity and overall reactivity showed stability only across 3-mo periods. Whereas no sex differences or sex?×?age interactions were found using the reactivity measures, when the measures of smiling and laughter, activity level, and vocal activity (which formed the positive reactivity composite when combined) were used independently, they showed an increase with age. Results support the use of the IBQ. (64 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The development of mother-infant and father-infant attachments in the second year of life.

Observed 20 infants at home interacting with their mothers, fathers, and an unfamiliar investigator, when they were 15, 18, 21, and 24 mo of age. The infants showed significant preferences for their fathers over their mothers in the display of attachment and affiliative behaviors. Both parents were preferred to the investigator on attachment behavior measures, though when the relative activity of the adults was taken into account, the infants directed more affiliative behaviors to the investigator than to their parents. Over the year, there were declines in the occurrence of most attachment and affiliative behaviors. Fathers were far more active in interaction with sons than with daughters. At 24 mo, the infants were observed in a laboratory playroom with their parents. In this situation, the infants showed no preference for either parent in the display of attachment and affiliative behaviors. They interacted far more with each parent when alone with her/him than when both parents were present. A stranger's presence had a similar effect on affiliative interaction within each parent–infant dyad, though the stranger effect was differentiated by intensification of the attachment behavior system. (32 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Serum sertraline and N-desmethylsertraline levels in breast-feeding mother-infant pairs

OBJECTIVE: The authors' goal was to study the serum sertraline levels of breast-feeding mothers and their infants. METHOD: They obtained serum levels of sertraline and N-desmethylsertraline in nine mother-infant pairs. RESULTS: Sertraline levels were very low (less than 2 ng/ml) in seven of the nine infants and low (3 ng/ml) in one. N-Desmethylsertraline levels were also low (6 ng/ml or less) in seven of the nine infants. One infant had a high level of N-desmethylsertraline, and one infant had unusual serum sertraline and N-desmethylsertraline values (half of its mother's levels). All infants were thriving. CONCLUSIONS: Most breast-feeding infants whose mothers were taking sertraline had very low serum levels of both sertraline and N-desmethylsertraline, consistent with published reports. The authors discuss in detail the one infant with unusually high levels.     

Time course of PCDD/PCDF/PCB concentrations in breast-feeding mothers and their infants

PCDD/PCDF/PCB concentrations were measured in samples from four mothers (at delivery and during lactation) and their infants (at birth and the end of first year of life). For two of these mothers it was the second delivery and breast-feeding period, and additional data were available from first lactation period and the first-born infant at the age of 11 to 12 months. Five of the six infants were fully breast-fed for at least 17 weeks. In four of them a distinct PCDD/PCDF/PCB accumulation was observed at the end of the first year of life: concentrations in blood fat were 1.5 to 3.6 times higher than maternal levels measured at the same time. Due to decreasing maternal body burdens during lactation, PCDD/PCDF concentrations at 11 to 12 months of life were only about half as high in the second infant as in the first one at the same age. During second pregnancy, no important change of the concentrations was observed in maternal blood.     

Origins of individual differences in infant shyness.

Explored the origins of individual differences in infant shyness by studying its relationship to parental shyness, sociability (the tendency to prefer being with others rather than alone), and introversion–extraversion (a factor that combines shyness, low sociability, and lack of impulsivity). The parents of 152 adopted and 120 nonadoptive infants (aged 12–24 mo) rated their child's shyness on a 5-item scale and completed the 16PF and measures of emotionality, activity, sociability, and impulsivity. In addition, information on biological mothers was obtained. The Family Environment Scale and the Home Observation for Measurement of the Environment were used to assess each infant's environment. Results show that infant shyness was positively related to shyness and negatively related to sociability and extraversion in nonadoptive mothers who shared both heredity and family environment with their infants. Genetic influence on infant shyness at 24 mo of age was shown by significant correlations of shyness and low sociability of biological mothers with shyness of their adopted-away infants. Infant shyness was also related to low sociability of adoptive mothers. (13 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Exposure of young infants to environmental tobacco smoke: breast-feeding among smoking mothers

OBJECTIVES: This study examined the degree to which breast-feeding and cigarette smoking by mothers and smoking by other household members contribute to the exposure of infants to the products of tobacco smoke. METHODS: The subjects were 330 mother-infant pairs derived from a cohort of 1000 pairs enrolled in a longitudinal study of the pulmonary effects of prenatal and postnatal smoking. The main outcome measure was corrected urinary cotinine levels. RESULTS: Urinary cotinine levels were 10-fold higher in breast-fed infants of smoking mothers than among bottle-fed infants of smoking mothers. Among infants of nonsmoking mothers, urine cotinine levels were significantly increased in infants living in homes with other smokers; in this group there was no significant difference between bottle-fed and breast-fed infants. Infants whose mothers smoked in the same room as the infant had only nonsignificant increases in cotinine levels compared with infants whose mothers restricted their smoking to other rooms. CONCLUSIONS: Breast-fed infants of smoking mothers have urine cotinine levels 10-fold higher than bottle-fed infants whose mothers smoke, suggesting that breast-feeding, rather than direct inhalation of environmental tobacco smoke, is the primary determinant of cotinine levels in infants whose mothers smoke.     

Maternal language in infancy.

Observations of 36 preterm infants and their English-speaking mothers suggest that maternal language to the infant varies as a function of the age and ordinal position of the infant and maternal education. The relationship between maternal language at 1 mo of age and the mother's verbal style to her older infant allows for early identification of maternal language input styles and, therefore, has important implications for mother–infant intervention programs. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

On cyclins, oocytes, and eggs

We studied the preventive effect against allergies in infants who and whose mothers consumed hypoallergenic formulas until 6 months after birth. Mother and infant pairs were divided into three groups, and the infants were monitored for the development of allergies for the first 2 years. In the MD group (n = 102; n = number of infants), the mothers were given a hypoallergenic formula for mothers (MOM HA), which contained hydrolyzed whey protein as the only protein source, as a substitution for cow's milk during late pregnancy and lactation. In the CD group (n = 127), the mothers were given cow's milk during the corresponding period. All infants in the MD and CD groups were exclusively breast-fed or mixed-fed with breast milk and hypoallergenic infant formula (NAN HA), which contains the same hydrolyzed protein as MOM HA. In the AF group (n = 54), the mothers consumed MOM HA and their infants were mixed-fed with breast milk and a cow's milk-based adopted infant formula during the corresponding period. In the MD group, no infants were positive to cow's milk-specific immunoglobulin E (RAST) at 4 months of age, in contrast to 6% and 3% of infants in the CD and AF groups, respectively. The infants in the MD group showed low incidence of various allergies, especially of eczema, as compared to the CD and AF groups. These results suggest that consumption of cow's milk by mothers and cow's milk-based formula feeding to infants elevate the risk of allergies in infants, and that consumption of hypoallergenic formula for pregnant and lactating women and for infants could be helpful in preventing allergy development in infants.