University of Missouri research paper: Social stigma often prevents African-American mothers from breastfeeding

10 Dec

Most medical personnel probably advise new mothers to breastfeed their babies. Alexandra Sifferlin wrote in the Time article, Why New Mothers Stop Breast-Feeding:

While nearly all mothers start breast-feeding their newborns, about half stop after a few weeks. The latest study explains why.
A team of researchers conducted over 2,700 interviews with 532 first-time mothers multiple times after they gave birth, starting 24 hours after delivery and ending at 60 days postpartum, about their breast-feeding choices. They report in the journal Pediatrics that women who worried from the start about their ability to nurse their infants were more likely to switch to formula sooner than those who didn’t have these concerns.
By the third day after delivering, over half of these women were worried about their babies’ ability to latch on, while 44% were concerned about breast-feeding pain, and 40% about their capacity to produce enough milk to nourish their infants.
These results support earlier studies that found that new moms often don’t have proper support and education about breast-feeding, which can lead to anxiety and a greater likelihood of stopping nursing. In January, TIME reported that hospitals may not offer women the resources they need to encourage women and address their anxiety…
http://healthland.time.com/2013/09/23/why-new-mothers-stop-breastfeeding/

See, Is the Medical Community Failing Breastfeeding Moms? http://healthland.time.com/2013/01/02/is-the-medical-community-failing-breastfeeding-moms/
There are some very good reasons why mothers should breastfeed their babies.

UNICEF Mozambique has a concise statement regarding the benefits of breastfeeding:

1. Breastmilk alone is the best food and drink for an infant for the first six months of life. No other food or drink, not even water, is usually needed during this period.
http://www.factsforlifeglobal.org/04/1.html
2. Newborn babies should be given to the mother to hold immediately after delivery. They should have skin-to-skin contact with the mother and begin breastfeeding within one hour of birth.
http://www.factsforlifeglobal.org/04/2.html
3. Almost every mother can breastfeed successfully. Breastfeeding the baby frequently causes production of more milk. The baby should breastfeed at least eight times daily, day and night, and on demand.
http://www.factsforlifeglobal.org/04/3.html
4. Breastfeeding helps protect babies and young children against dangerous illnesses. It also creates a special bond between mother and child.
http://www.factsforlifeglobal.org/04/4.html
5. Bottle feeding and giving a baby breastmilk substitutes such as infant formula or animal milk can threaten the baby’s health and survival. If a woman cannot breastfeed her infant, the baby can be fed expressed breastmilk or, if necessary, a quality breastmilk substitute from an ordinary clean cup.
http://www.factsforlifeglobal.org/04/5.html
6. If a woman is infected with HIV, there is a risk that she can pass the infection to her infant through breastfeeding. In the first six months, this risk is much greater if the infant is fed both breastmilk and other liquids and foods than if fed breastmilk alone. Therefore, it is recommended that the baby receives breastmilk alone for the first six months, unless it is acceptable, feasible, affordable, sustainable and safe to give breastmilk substitutes (infant formula) exclusively.
http://www.factsforlifeglobal.org/04/6.html
7. A woman employed away from her home can continue to breastfeed her child. She should breastfeed as often as possible when she is with the infant and express her breastmilk when they are apart so that another caregiver can feed it to the baby in a clean and safe way.
http://www.factsforlifeglobal.org/04/7.html
8. After 6 months of age, when babies begin to eat foods, breastfeeding should continue for up to two years and beyond because it is an important source of nutrition, energy and protection from illness.
http://www.factsforlifeglobal.org/04/8.html
For more information, please contact:
Arild Drivdal, UNICEF Mozambique, tel. (+258) 21 481 100; email: maputo@unicef.org
Gabriel Pereira, UNICEF Mozambique, tel. (+258) 21 481 100; email: maputo@unicef.org
http://www.unicef.org/mozambique/media_9256.html

See, the Benefits of Breastfeeding https://www.llli.org/nb/nbbenefits.html

Urmeka Jefferson, assistant professor at the University of Missouri’s Sinclair School of Nursing, presented the paper, Contribution of Breastfeeding Exposure and Attitudes to Breastfeeding Intentions of Black College Students at the National Association of Neonatal Nurses’ NANN’s 29th Annual Educational Conference.

Here is the press release from the University of Missouri:

Social Stigmas against Breast-feeding May Contribute to African-American College Students’ Hesitation to Breast-feed Future Children, MU Researcher Says
Dec. 04, 2013
Story Contact(s):
Jesslyn Chew, ChewJ@missouri.edu, (573) 882-8353
By Anne Allen
COLUMBIA, Mo. – African-American mothers breast-feed their children at lower rates than Caucasian, Latina and Asian mothers. This difference often has been attributed to socio-demographic factors such as age, income, education and personal experience with breast-feeding. Now, a researcher at the University of Missouri has discovered that African-American college students are aware of the benefits of breast-feeding for infants, yet some still are hesitant about breast-feeding future children. Evidence revealed a lack of public acceptance toward breast-feeding may influence this hesitation.
“We need to start early with our breast-feeding education and exposure because women decide before they have children whether or not they will breast-feed,” Urmeka Jefferson, assistant professor at the Sinclair School of Nursing, said. “We need to figure out how to encourage positive breast-feeding attitudes among young Black women and make them aware that breast-feeding is the normal, natural infant-feeding method.”
Jefferson surveyed African-American college students about their attitudes and exposure to breast-feeding and their intent to breast-feed future children. She found the majority of students knew the benefits of breast-feeding and had some level of previous exposure, such as friends or parents who had breast-fed their infants. Despite their knowledge of the benefits of breast-feeding, many students felt formula-feeding was more convenient and a better choice if the mother worked outside the home. The overwhelming majority of students surveyed also expressed discomfort at the idea of breast-feeding in public places, such as a restaurant. Jefferson concluded that this discomfort may have less to do with racial or socio-demographic disparities and more to do with social stigmas against breast-feeding.
“Encouraging public acceptance of breast-feeding is important,” Jefferson said. “Our American culture tends to add a sexual connotation to breast-feeding that is false, and we have to do more to change social perceptions so that women feel more comfortable breast-feeding in public. If we can get the message out to women and men before they have children, we’ll have more parents who are knowledgeable about breast-feeding and intend to breast-feed their children.”
Mothers choosing to breast-feed despite the negative social attitude surrounding it demonstrate a stronger intention and desire to do what is beneficial for their infants and themselves, Jefferson said. Children who are breast-fed are more resistant to disease and infection, while mothers who breast-feed are less likely to develop postpartum depression and breast cancer, Jefferson said.
Jefferson received the National Association of Neonatal Nurses research abstract award for her study, titled “Contribution of Breast-feeding Exposure and Attitudes to Breast-feeding Intentions of Black College Students.” In her future research, Jefferson hopes to identify the specific factors that may influence African-American women’s decisions to breast-feed their infants.

Citation:

Research Abstract Award
301) Contribution of Breastfeeding Exposure and Attitudes to Breastfeeding Intentions of Black College Students
Urmeka Jefferson, PhD, RNC-LRN, University of Missouri, Columbia, MO
Significance: Lack of exposure to Black mothers breastfeeding may contribute to low breastfeeding rates among Black women. Previous research has not explored the role of breastfeeding exposure on Black women’s breastfeeding intentions.
Purpose: To explore breastfeeding exposure, attitudes, and intentions of Black college students.
Research Questions: 1) What are the breastfeeding exposure, attitudes, and intentions of Black college students? 2) How well does breastfeeding exposure and attitudes predict intentions after controlling for age, gender, income, and education level?
Methods: A descriptive cross-sectional study guided by the theory of planned behavior was conducted. A convenience sample of 348 Black college students
Results: Students demonstrated positive breastfeeding attitudes (mean attitude score = 53.54), knew someone who breastfed their infant (83.4%), and were breastfed as infants (40.4%). Exposure to breastfeeding was associated with attitude scores >55 and a high probability (81-100%) to breastfeed future children. Breastfeeding exposure and attitudes explained 22% of the variance in breastfeeding intentions with attitude the strongest contributor.
Implications for Practice/Research: Findings of this study demonstrate beliefs about infant feeding are formed before having children. Therefore, interventions focused on increasing breastfeeding among Black women should target young women before becoming pregnant and include efforts to improve breastfeeding attitudes. Images of Black women breastfeeding displayed in the community will also promote breastfeeding as the natural choice for infants and expose women to breastfeeding.
Learning Objectives
1. Identify factors influencing breastfeeding among Black women.
2. Discuss the contribution of breastfeeding exposure and attitudes to breastfeeding intentions.
3. Discuss implications for practice and research.
http://www.nann.org/uploads/2013_Conference/FINAL_Paper_Presentations.pdf

There are disadvantages for bottle fed babies. The University of Wisconsin Health Center succinctly discussed the disadvantages of bottle feeding in Bottle-Feeding: Disadvantages for Babies:

Bottle-Feeding: Disadvantages for Babies
Topic Overview
Infant formulas take two times longer for a baby to digest than breast milk. The slower digestion of infant formula can affect:
Feeding frequency. Babies who take infant formula usually want to feed less often than babies who are breast-feeding.
Sleeping patterns. Babies who take infant formula may sleep longer at night once they are about 2 months old. But babies who are breast-fed usually catch up shortly after, at about 3 to 5 months of age.
Bowel movements. Infant formula causes formed, brown stools that have a noticeable odor. Breast milk causes loose, yellow stools that have less odor.
Breast milk, unlike formula, has antibodiesClick here to see more information.. Breast-feeding may lower your child’s risk for many types of infections and allergies. Breast milk may also help protect your child from some health problems, such as eczema, asthma, and diabetes. For more information, see the topic Breast-Feeding.
Related Information
Last Revised: August 1, 2011
Author: Healthwise Staff
Medical Review: John Pope, MD – Pediatrics & Thomas Emmett Francoeur, MD, MDCM, CSPQ, FRCPC – Pediatrics
http://www.uwhealth.org/health/topic/special/bottlefeeding-disadvantages-for-babies/tj8029.html

See, Breast-Feeding vs. Bottle-Feeding http://psychcentral.com/lib/breast-feeding-vs-bottle-feeding/0001228
Researchers are looking at the link between baby formula and adult obesity.

Kathleen Miles reported in the Huffington Post article, Baby Formula May Increase Risk Of Adult Obesity, Diseases, Study Says:

Formula-fed babies may grow too quickly and may be more susceptible than breastfed babies to obesity and other chronic diseases later in life, a new study says.
Five formula-fed baby rhesus monkeys grew faster and larger than five breastfed rhesus monkey babies, and had higher insulin levels after just one week, lead study author Carolyn Slupsky, a researcher at University of California, Davis, told The Huffington Post. The study was funded by Fonterra Research and Development Centre, an arm of the New Zealand-based global dairy giant, which makes baby formula, and was published in the June issue of Journal of Proteome Research.
“This is the fist time somebody has glimpsed into the mechanism of what’s going on with formula,” Slupsky said. The results, she said, should be “a call to arms to the formula companies to come up with better formulas that are going to ensure the health of our future population.”
The UC Davis researchers closely monitored the monkey babies’ weight and feeding, and took weekly blood and urine samples for three months.
In addition to having higher insulin and amino acid levels, the formula-fed babies had microbes in their digestive tracts that were “completely different” than those in the breastfed babies, the study says. This may put formula-fed babies at a higher risk of a wide range of health issues, such as obesity, diabetes, liver problems and cardiovascular disease, Slupsky said.
Part of the difference may be explained by an excess of protein in formula milk. Human milk is 8 percent to 9 percent protein, and rhesus monkey milk is 11.6 percent protein. But formula has 18.3 percent protein. “The quality of protein in formula is not the same as in human milk, so formula companies decided to add more of it to make up for any deficits,” Slupsky explained. “But that may be problematic.”
A study in 2010 suggested that parents may overfeed bottle-fed babies, while breastfed babies limit their intake because they have to work hard to get it. Slupsky said she does not think that was a factor in her study because the formula-fed baby monkeys fed themselves by sucking on a bottle when they were hungry.
Slupsky said researchers at UC Davis are working with formula companies to create formula that more closely resembles human breast milk.
http://www.huffingtonpost.com/2013/08/12/baby-formula-disease-study_n_3728706.html

Citation:

Early Diet Impacts Infant Rhesus Gut Microbiome, Immunity, and Metabolism
Aifric O’Sullivan ‡§, Xuan He ‡, Elizabeth M. S. McNiven ‡, Neill W. Haggarty , Bo Lönnerdal ‡, and Carolyn M. Slupsky *‡§
‡Department of Nutrition, §Department of Food Science and Technology, One Shields Avenue,University of California, Davis, Davis, California 95616, United States
Fonterra Ingredients Innovation, Fonterra Co-operative Group, Private Bag 11029, Fitzherbert Dairy Farm Road, Palmerston North, New Zealand
J. Proteome Res., 2013, 12 (6), pp 2833–2845
DOI: 10.1021/pr4001702
Publication Date (Web): May 7, 2013
Copyright © 2013 American Chemical Society
*E-mail: cslupsky@ucdavis.edu. Ph: (530) 752-6804. Fax:(530) 752-8966.
http://pubs.acs.org/doi/abs/10.1021/pr4001702?journalCode=jprobs

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