Nutrition Research and Practice

The Korean Nutrition Society (한국영양학회)
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Compliance of mothers' breastfeeding and complementary feeding practices with WHO recommendations in Turkey

  • Received : 2019.09.24
  • Accepted : 2020.05.30
  • Published : 2020.12.01
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Abstract

BACKGROUND/OBJECTIVES: This study aimed to evaluate how breastfeeding and complementary nutrition practices of mothers of 0-24-month-old children comply with the World Health Organization (WHO) recommendations for infant and young child feeding and to compare the results with selected demographic parameters related to the mother and child. SUBJECTS/METHODS: The research sample comprised mothers (n = 250) with children less than 2 years old. Data were obtained via questionnaire and were analyzed using SPSS 20.0 package program. The Pearson χ2 or Fisher's exact tests were used for assessing relationships between categorical variables. The one-sample t-test was used for comparisons with reference values. RESULTS: Most mothers (97.2%) breastfed their babies immediately after birth. The mean time to breastfeeding after delivery was 47.8 ± 14.8 minutes, and 40.8% of the mothers complied with the WHO recommendation. Furthermore, 59.8% of the mothers exclusively breastfed their children for 6 months (mean 5.2 ± 1.5 months). The mean duration to the start of providing complementary food was 5.8 ± 0.6 months, and 76.1% of mothers who complied with the WHO recommendation. Only 12.3% of mothers breastfed their children for at least 12 months (mean 7.7 ± 3.3 months). On average, mothers gave cow milk to their children for the first time at 10.1 ± 1.7 months and honey at 11.8 ± 2.3 months. The mothers' rates of compliance with the WHO recommendations on cow milk and honey feeding were 32.0% and 71.6%, respectively. The rate of mothers who complied with the WHO minimum meal frequency recommendation was 88.3%. CONCLUSIONS: We suggest that the WHO recommendations on this subject will be realized more fully by emphasizing the importance of the positive effects of breastfeeding until the age of 2 years and of a timely start of complementary food provision. Such changes will affect child health over the long term.

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References

  1. Arlotti JP, Cottrell BH, Lee SH, Curtin JJ. Breastfeeding among low-income women with and without peer support. J Community Health Nurs 1998;15:163-78. https://doi.org/10.1207/s15327655jchn1503_4
  2. Leung AK, Sauve RS. Breast is best for babies. J Natl Med Assoc 2005;97:1010-9.
  3. World Health Organization. Complementary Feeding: Report of the Global Consultation and Summary of Guiding Principles for Complementary Feeding of the Breastfed Child. Geneva: World Health Organization; 2002.
  4. Savage JS, Fisher JO, Birch LL. Parental influence on eating behavior: conception to adolescence. J Law Med Ethics 2007;35:22-34. https://doi.org/10.1111/j.1748-720X.2007.00111.x
  5. Agostoni C, Decsi T, Fewtrell M, Goulet O, Kolacek S, Koletzko B, Michaelsen KF, Moreno L, Puntis J, Rigo J, Shamir R, Szajewska H, Turck D, van Goudoever J; ESPGHAN Committee on Nutrition. Complementary feeding: a commentary by the ESPGHAN Committee on Nutrition. J Pediatr Gastroenterol Nutr 2008;46:99-110. https://doi.org/10.1097/01.mpg.0000304464.60788.bd
  6. The United Nations International Children's Emergency Fund (UNICEF) and The Global Strategy on Infant and Young Child Feeding (GSIYCF). Understanding the past-planning the future [Internet]. New York: The United Nations International Children's Emergency Fund; 2011 [cited 2015 October 15]. Available from: http://www.unicef.org/nutrition/files/FinalReportonDistribution.pdf.
  7. World Health Organization. Indicators for Assessing Infant and Young Child Feeding Practices PART 3 Country Profiles. Geneva: World Health Organization; 2010.
  8. Republic of Turkey Ministry of Health Turkey. Nutrition and Health Survey Final Report: No:931, 2010. Ankara: Republic of Turkey Ministry of Health Turkey Publications; 2014.
  9. Faul F, Erdfelder E, Lang AG, Buchner A. G*Power 3: a flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav Res Methods 2007;39:175-91. https://doi.org/10.3758/BF03193146
  10. World Health Organization. WHO European region has lowest global breastfeeding rates 2019. Geneva: World Health Organization; 2015 [cited 2020 March 23]. Available from: http://www.euro.who.int/en/health-topics/Life-stages/maternal-and-newborn-health/news/news/2015/08/who-european-region-has-lowest-global-breastfeeding-rates.
  11. Hacettepe University Institute of Population Studies. Turkey Demographic Health Survey-2018. Ankara: Elma Teknik Basim Matbaacilik; 2019.
  12. Carletti C, Pani P, Knowles A, Monasta L, Montico M, Cattaneo A. Breastfeeding to 24 months of age in the northeast of Italy: a cohort study. Breastfeed Med 2011;6:177-82. https://doi.org/10.1089/bfm.2011.0019
  13. World Health Organization/The United Nations International Children's Emergency Fund (WHO/UNICEF). Global nutrition targets 2025: Breastfeeding policy brief (WHO/NMH/NHD/14.7) 2014 [Internet]. Geneva: World Health Organization; 2020 [cited 2019 December 3]. Available from: https://www.who.int/nutrition/topics/globaltargets_breastfeeding_policybrief.pdf.
  14. World Health Organization. Infant and young child feeding-Key facts. 2019 [Internet]. Geneva: World Health Organization; 2020 [cited 2019 December 3]. Available from: https://www.who.int/news-room/fact-sheets/detail/infant-and-young-child-feeding.
  15. Kimani-Murage EW, Madise NJ, Fotso JC, Kyobutungi C, Mutua MK, Gitau TM, Yatich N. Patterns and determinants of breastfeeding and complementary feeding practices in urban informal settlements, Nairobi Kenya. BMC Public Health 2011;11:396. https://doi.org/10.1186/1471-2458-11-396
  16. Lauer JA, Betran AP, Victora CG, de Onis M, Barros AJ. Breastfeeding patterns and exposure to suboptimal breastfeeding among children in developing countries: review and analysis of nationally representative surveys. BMC Med 2004;2:26. https://doi.org/10.1186/1741-7015-2-26
  17. World Health Organization. Breastfeeding in the 21st century [Internet]. Geneva: World Health Organization; 2020 [cited 2020 March 23]. Available from: https://www.who.int/pmnch/media/news/2016/ breastfeeding_brief.pdf.
  18. Hornell A, Lagstrom H, Lande B, Thorsdottir I. Breastfeeding, introduction of other foods and effects on health: a systematic literature review for the 5th Nordic Nutrition Recommendations. Food Nutr Res 2013;57:1-26.
  19. Semahegn A, Tesfaye G, Bogale A. Complementary feeding practice of mothers and associated factors in Hiwot Fana Specialized Hospital, Eastern Ethiopia. Pan Afr Med J 2014;18:143.
  20. Tarini BA, Carroll AE, Sox CM, Christakis DA. Systematic review of the relationship between early introduction of solid foods to infants and the development of allergic disease. Arch Pediatr Adolesc Med 2006;160:502-7. https://doi.org/10.1001/archpedi.160.5.502
  21. Gubbels JS, Thijs C, Stafleu A, van Buuren S, Kremers SP. Association of breast-feeding and feeding on demand with child weight status up to 4 years. Int J Pediatr Obes 2011;6:e515-22. https://doi.org/10.3109/17477166.2010.514343
  22. Monasta L, Batty GD, Cattaneo A, Lutje V, Ronfani L, Van Lenthe FJ, Brug J. Early-life determinants of overweight and obesity: a review of systematic reviews. Obes Rev 2010;11:695-708. https://doi.org/10.1111/j.1467-789X.2010.00735.x
  23. Moura EF. Duration of breastfeeding of children visiting a pediatric outpatient unit. J Pediatr (Rio J) 1997;73:106-10. https://doi.org/10.2223/JPED.516
  24. Campos AM, Chaoul CO, Carmona EV, Higa R, do Vale IN. Exclusive breastfeeding practices reported by mothers and the introduction of additional liquids. Rev Lat Am Enfermagem 2015;23:283-90. https://doi.org/10.1590/0104-1169.0141.2553
  25. Chapagain RH. Factors affecting complementary feeding practices of Nepali mothers for 6 months to 24 months children. J Nepal Health Res Counc 2013;11:205-7.
  26. Parekh C, Bavdekar SB, Shaharao V. Study of infant feeding practices: factors associated with faulty feeding. J Trop Pediatr 2004;50:306-8. https://doi.org/10.1093/tropej/50.5.306
  27. Aggarwal A, Verma S, Faridi M; Dayachand. Complementary feeding--reasons for inappropriateness in timing, quantity and consistency. Indian J Pediatr 2008;75:49-53. https://doi.org/10.1007/s12098-008-0006-9
  28. Carletti C, Pani P, Monasta L, Knowles A, Cattaneo A. Introduction of complementary foods in a cohort of infants in Northeast Italy: do parents comply with WHO recommendations? Nutrients 2017;9:34. https://doi.org/10.3390/nu9010034
  29. Koletzko B, Beyer J, Brands B, Demmelmair H, Grote V, Haile G, Gruszfeld D, Rzehak P, Socha P, Weber M; European Childhood Obesity Trial Study Group. Early influences of nutrition on postnatal growth. Nestle Nutr Inst Workshop Ser 2013;71:11-27.
  30. Moy RJ. Prevalence, consequences and prevention of childhood nutritional iron deficiency: a child public health perspective. Clin Lab Haematol 2006;28:291-8. https://doi.org/10.1111/j.1365-2257.2006.00793.x
  31. Lozoff B, Clark KM, Jing Y, Armony-Sivan R, Angelilli ML, Jacobson SW. Dose-response relationships between iron deficiency with or without anemia and infant social-emotional behavior. J Pediatr 2008;152:696-702. https://doi.org/10.1016/j.jpeds.2007.09.048
  32. Hochwallner H, Schulmeister U, Swoboda I, Spitzauer S, Valenta R. Cow's milk allergy: from allergens to new forms of diagnosis, therapy and prevention. Methods 2014;66:22-33. https://doi.org/10.1016/j.ymeth.2013.08.005
  33. Luyt D, Ball H, Makwana N, Green MR, Bravin K, Nasser SM, Clark AT; Standards of Care Committee (SOCC) of the British Society for Allergy and Clinical Immunology (BSACI). BSACI guideline for the diagnosis and management of cow's milk allergy. Clin Exp Allergy 2014;44:642-72. https://doi.org/10.1111/cea.12302
  34. Larnkjaer A, Hoppe C, Molgaard C, Michaelsen KF. The effects of whole milk and infant formula on growth and IGF-I in late infancy. Eur J Clin Nutr 2009;63:956-63. https://doi.org/10.1038/ejcn.2008.80
  35. Tanzi MG, Gabay MP. Association between honey consumption and infant botulism. Pharmacotherapy 2002;22:1479-83. https://doi.org/10.1592/phco.22.16.1479.33696
  36. Kitano N, Nomura K, Kido M, Murakami K, Ohkubo T, Ueno M, Sugimoto M. Combined effects of maternal age and parity on successful initiation of exclusive breastfeeding. Prev Med Rep 2015;3:121-6. https://doi.org/10.1016/j.pmedr.2015.12.010
  37. Colombo L, Crippa BL, Consonni D, Bettinelli ME, Agosti V, Mangino G, Bezze EN, Mauri PA, Zanotta L, Roggero P, Plevani L, Bertoli D, Gianni ML, Mosca F. Breastfeeding determinants in healthy term newborns. Nutrients 2018;10:48. https://doi.org/10.3390/nu10010048
  38. Liu P, Qiao L, Xu F, Zhang M, Wang Y, Binns CW. Factors associated with breastfeeding duration: a 30-month cohort study in northwest China. J Hum Lact 2013;29:253-9. https://doi.org/10.1177/0890334413477240
  39. Sipsma HL, Jones K, Nickel NC. Hospital practices to promote breastfeeding: the effect of maternal age. Birth 2017;44:272-80. https://doi.org/10.1111/birt.12284
  40. Bagul AS, Supare MS. The infant feeding practices in an urban slum of nagpur, India. J Clin Diagn Res 2012;6:1525-7. https://doi.org/10.7860/JCDR/2012/4622.2549
  41. Bai DL, Fong DY, Tarrant M. Factors associated with breastfeeding duration and exclusivity in mothers returning to paid employment postpartum. Matern Child Health J 2015;19:990-9. https://doi.org/10.1007/s10995-014-1596-7
  42. Kumar V, Arora G, Midha IK, Gupta YP. Infant and young child feeding behaviors among working mothers in India: Implications for global health policy and practice. Int J MCH AIDS 2015;3:7-15.
  43. Bag O, Yaprak I, Halicioglu O, Parlak O, Harputluoglu N. Annelerin anne sutu hakkindaki bilgi duzeyi ve emzirmeyi etkileyen psikososyal faktorler. Tepecik Egitim ve Arastirma Hastanesi Dergisi 2006;16:63-70.
  44. Dobele A, Fry J, Thiele SR, Fry T. Caring for baby: What sources of information do mothers use and trust? J Serv Mark 2017;31:677-89. https://doi.org/10.1108/JSM-02-2015-0104
  45. Unsal H, Atlihan F, Ozkan H, Targan S, Hassoy H. Toplumda anne sutu verme egilimi ve buna etki eden faktorler. Cocuk Sagligi Hastalik Derg 2005;48:226-33.
  46. Moore ER, Coty MB. Prenatal and postpartum focus groups with primiparas: breastfeeding attitudes, support, barriers, self-efficacy, and intention. J Pediatr Health Care 2006;20:35-46. https://doi.org/10.1016/j.pedhc.2005.08.007
  47. Inanc BB. 15-49 Yas Arasi Annelerin Anne Sutu ile Ilgili Uygulamalari ve Etki Eden Faktorleri. Turk Aile Hek Derg 2013;17:51-5. https://doi.org/10.2399/tahd.13.63835
  48. Yilmaz E, Doga Ocal F, Vural Yilmaz Z, Ceyhan M, Kara OF, Kucukozkan T. Early initiation and exclusive breastfeeding: Factors influencing the attitudes of mothers who gave birth in a baby-friendly hospital. Turk J Obstet Gynecol 2017;14:1-9.