• Journal of Preventive Medicine and Public Health
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• v.56 no.4
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• pp.338-347
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• 2023

Objectives: Young children's feeding characteristics can play an important role in eating habits and health during later childhood. This study was conducted to examine the associations of feeding characteristics with dietary patterns and obesity in children. Methods: This study utilized data from the Korea National Health and Nutrition Examination Survey conducted between 2013 and 2017. In total, 802 toddlers were included, with information on their demographic characteristics, feeding practices and duration, and 24-hour recall obtained from their parents. Feeding characteristics were categorized into feeding type, duration of total breastfeeding, duration of total formula feeding, duration of exclusive breastfeeding, and age when starting formula feeding. Dietary patterns were identified based on factor loadings for the food groups for 3 major factors, with "vegetables & traditional," "fish & carbohydrates," and "sweet & fat" patterns. Overweight/obesity was defined as ≥85th percentile in body mass index based on the 2017 Korean National Growth charts for children and adolescents. Multiple regression analysis was conducted to examine associations between feeding characteristics and dietary patterns. The association between dietary patterns and obesity was analyzed using multivariable logistic regression analysis. Results: The early introduction of formula feeding was inversely associated with the "vegetables & traditional" pattern (β=-0.18; 95% confidence interval [CI], -0.34 to -0.02). A higher "vegetables & traditional" intake was associated with a lower risk of obesity (odds ratio, 0.48; 95% CI, 0.24 to 0.95). Conclusions: Feeding characteristics are associated with dietary patterns in later childhood, and dietary patterns were shown to have a potential protective association against obesity.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.24 no.6
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• pp.501-509
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• 2021

Extensive studies have shown that breast milk is the best source of nutrition for infants, especially during the first six months, because it fulfills almost all of their nutritional needs. Among the many functional building blocks in breast milk, human milk oligosaccharides (HMOs) have been receiving more attention recently. Furthermore, it is the third most common group of compounds in human milk, and studies have demonstrated the health benefits it provides for infants, including improved nutritional status. HMOs were previously known as the 'bifidus factor' due to their 'bifidogenic' or prebiotic effects, which enabled the nourishment of the gastrointestinal microbiota. Healthy gastrointestinal microbiota are intestinal health substrates that increase nutrient absorption and reduce the incidence of diarrhea. In addition, HMOs, directly and indirectly, protect infants against infections and strengthen their immune system, leading to a positive energy balance and promoting normal growth. Non-modifiable factors, such as genetics, and modifiable factors (e.g., maternal health, diet, nutritional status, environment) can influence the HMO profile. This review provides an overview of the current understanding of how HMOs can contribute to the prevention and treatment of nutritional issues during exclusive breastfeeding.

• Korean Journal of Community Nutrition
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• v.24 no.2
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• pp.97-105
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• 2019

Objectives: This study examined whether the infant feeding type and duration are related to the introduction of complementary feeding, and whether the appropriate introduction of complementary feeding in infancy is related to tooth decay in toddlers. Methods: The subjects were 1,521 toddlers among 2~3 year old children in the Korea National Health and Nutrition Examination Survey from 2008 to 2015. The toddlers were divided into the appropriate group (4~6 months) and delayed group (>6 months) according to the timing of complementary feeding introduction. Results: The delayed group were 26.5% of subjects and the formula feeding period in the appropriate group and delayed group was 8.4 and 10.3 months, respectively (P=0.002). On the other hand, there was no difference in the breastfeeding period between the appropriate group and delayed group (P=0.6955). Early childhood caries was more common in the delayed group (P=0.0065). The delayed introduction of complementary feeding was associated with a risk of early childhood caries according to the logistic models (OR 1.81, 95% CI 1.27-2.57). Conclusions: The introduction of complementary feeding is associated with early childhood caries. Therefore, the importance of the proper introduction of complementary feeding in infancy should be emphasized, and public relations and education for maternal care and breastfeeding should be provided through health care institutions.

• Clinical and Experimental Pediatrics
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• v.63 no.9
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• pp.361-367
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• 2020

Background: Length of stay is a significant indicator of care effectiveness and hospital performance. Owing to the limited number of healthcare centers and facilities, it is important to optimize length of stay and associated factors. Purpose: The present study aimed to investigate factors associated with neonatal length of stay in the neonatal intensive care unit (NICU) using parametric and semiparametric models and compare model fitness according to Akaike information criterion (AIC) between 2016 and 2018. Methods: This retrospective cohort study reviewed 600 medical records of infants admitted to the NICU of Bandar Abbas Hospital. Samples were identified using census sampling. Factors associated with NICU length of stay were investigated based on semiparametric Cox model and 4 parametric models including Weibull, exponential, log-logistic, and log-normal to determine the best fitted model. The data analysis was conducted using R software. The significance level was set at 0.05. Results: The study findings suggest that breastfeeding, phototherapy, acute renal failure, presence of mechanical ventilation, and availability of central venous catheter were commonly identified as factors associated with NICU length of stay in all 5 models (P<0.05). Parametric models showed better fitness than the Cox model in this study. Conclusion: Breastfeeding and availability of central venous catheter had protective effects against length of stay, whereas phototherapy, acute renal failure, and mechanical ventilation increased length of stay in NICU. Therefore, the identification of factors associated with NICU length of stay can help establish effective interventions aimed at decreasing the length of stay among infants.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.10
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• pp.6147-6150
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• 2013

Background: Breast feeding is considered to be mutually beneficial for both mothers and infants, though the effect of lactation problems on development of breast lesions (whether benign or malignant) is not clear. Objectives: This study was conducted to identify possible relations between lactation problems and benign and malignant breast disease. Materials and Methods: 308 patients referred to two referral breast clinics in Tehran, the capital city of IR Iran, between January 2008 and January 2011, were recruited. They were interviewed by a standard questionnaire regarding breast feeding problems. The study population was classified in 3 major groups; breast feeding without any problem, unwillingness to breast feed according to whether mothers' preference not to feed or some breast problems like mastitis, and finally insufficient milk that caused the mothers to feed their babies with formula. Results: Recruiting binary logistic regression method, mother's unwillingness to feed her child by breast milk, and also breast problems such as mastitis and abscess during lactation period showed significant relation with both benign and malignant breast diseases (p value<0.01). Surprisingly, inadequate milk was not associated with any of these conditions. Conclusions: We concluded that lactation problems which involve normal milk drainage from the breast may play an important role in whether the mother wll subsequently develope both benign and malignant pathologies. In contrast in the situation that the production of the milk is not sufficient and there are no intentional or unintentional problems in drainage of the produced milk, future problems would not be more common.

• Research in Community and Public Health Nursing
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• v.30 no.1
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• pp.90-98
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• 2019

Purpose: The purpose of this study is to identify the association between maternal feeding practices and excessive weight gain in infants. Methods: This study adopted a cross-sectional design and included 240 pairs of mothers and their infants (129 boys and 111 girls) in public healthcare centers in the Daejeon area in South Korea. Via multivariate analyses, the association between maternal feeding practices and excessive weight gain in infants was identified. Results: Among 240 infants in this study, 39 (16.3%) infants gained excessive weight during 12 months after birth. Using multivariate logistic regression with adjustment for covariates, more than 7 months of exclusive breastfeeding was associated with a reduced likelihood of excessive weight gain in infants during the 12 months after birth (adjusted odds ratio: 0.39, 95% confidence interval: 0.02~0.81, p=.029). Conclusion: Based on these results, nurses in communities and clinics should educate mothers on the importance of longer durations of exclusive breast feeding and develop strategies for encouraging such behavior. Furthermore, support for exclusive breast feeding should be provided in various settings.

• Women's Health Nursing
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• v.6 no.4
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• pp.632-642
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• 2000

This study was carried out to investigate effect of education for breastfeeding on practice of breastfeeding 171 primiparae (experimental group with education 83 and control group without education 88) who gave birth in hospitals located in Taegu City from October 25, 1999 to December 25, 1999 and planned to breastfeed their children after childbirth. The results of this study were as follows. 1) The experimental group's practice rate of breast-feeding was statistically higher than the control group's at the points of two weeks, four weeks, eight weeks and twelve weeks after childbirth(p<0.05). However, the rate at the points of sixteen weeks and twenty weeks after childbirth was higher in the experimental group than in the control group but there was no significant difference between both groups. 2) The experimental group's discontinuance rate of breast-feeding was lower than the control group's at all the points of two weeks, four weeks, eight weeks, twelve weeks, sixteen weeks and twenty weeks after childbirth, and it was statistically significant(p<0.05). The discontinuance rate of breast-feeding at the point of four weeks after childbirth was the highest in both groups. It accounted for 25.5% in the experimental group and 36.8% in the control group. 3) The reason of which the rate appeared to be the highest among those for discontinuance of breast-feeding was the lack of breast milk. The rate accounted for 65.5% in the experimental group and 50.7% in the control group. In conclusion, the study suggested that the education for encouraging breast-feeding provided to the primiparae after childbirth has an positive effect on the practice of breast-feeding.

• Journal of Preventive Medicine and Public Health
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• v.41 no.4
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• pp.232-240
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• 2008

Objectives: This study was conducted to assess the nutritional status and characteristics related to malnutrition in children less than five years of age in Nghean, Vietnam. Methods: In this study, which was conducted in November 2007, 650 child-mother pairs were selected using a two-stage cluster sampling methodology. A structured questionnaire was then administered to the mothers in their home settings. Anthropometric measurement was then used to determine if children were underweight (weight-for-age), wasting (weight-for-height) and stunting (height-for-age) based on reference data from the National Center for Health Statistics (NCHS)/World Health Organization (WHO). Logistic regression analysis was then used to describe the hierarchical relationships between potential risk factors and malnutrition. Results: The mean Z-scores for weight-for-age, height-for-age and weight-for-height were -1.46 (95% CI=-1.57, -1.35), -1.44 (95% CI=-1.56, -1.32) and -0.71 (95% CI=-0.82, -0.60), respectively. Of the children included in this study, 193 (31.8%) were underweight, 269 (44.3%) were stunting and 72 (11.9%) were wasting. Region of residence, the mother's level of education and occupation, household size, number of children in the family, weight at birth and duration of exclusive breastfeeding were found to be significantly related to malnutrition. Conclusions: The findings of this study indicate that malnutrition is still an important problem among children less than five years of age in Nghean, Vietnam. In addition, maternal, socio-economic and environment factors were found to be significant factors for malnutrition among children under five.

• Journal of Preventive Medicine and Public Health
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• v.41 no.3
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• pp.181-185
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• 2008

Objectives : This study was performed to evaluate the reproducibility of a questionnaire concerned with reproductive history and to ascertain which characteristics of the subjects (age, the visit-revisit intervals, education and chronic disease) are associated with good reliability in the Korean Multi-Center Cancer Cohort (KMCC) study. Materials and Methods: A total of 19,688 participants were enrolled between 1993 and 2004. Among them, we selected 386 participants who were aged 40 or more and who re-visited within 8 years after the first visit. Reliability was measured by the percent agreement according to error range for the continuous variables and the percent agreement and kappa statistics for the categorical variables. Results : The pregnancy histories were reliable (kappa=0.67) and the reasons for being menopausal among the postmenopausal women were also reliable (kappa=0.92). The percent agreement of the breast-feeding history was high (96.1%), although the kappa statistic was low. For the continuous variables, when the error range of one variable was considered to be reliable, the percent agreement of the age at menarche and the age at the first full term pregnancy was good (69.4% and 83.6%), whereas that of the age at menopause was low (51.5%). The factors associated with high reliability were a younger age, the presence of chronic disease and a short visit-revisit time interval. Conclusions : The agreements for parity, the reasons for menopause, and the breastfeeding history in the reproductive history questionnaire used in the KMCC were relatively good. The questionnaire for the menarche age and the menopausal age might have lower reliability due to the difference between Korean age and American age. To obtain reliable information, more attention should be given to the items in questionnaire-based surveys, and especially for surveying old-aged women.