Percepción e intención de practicar la lactancia materna en adolescentes del noreste de México / Perception and intention to practice breastfeeding in adolescents in northeastern Mexico

Resumen: Objetivo: Analizar la percepción e intención de práctica de la lactancia materna (LM) en adolescentes de ambos sexos que aún no han sido padres. Material y métodos: Se efectuó un estudio cualitativo basado en la teoría fundamentada y siguiendo el criterio de la saturación empírica. Se realizaron 21 entrevistas semiestructuradas a estudiantes entre 15 y 18 años de edad en preparatorias de la ciudad de Monterrey, Nuevo León, México. Resultados: Se identificaron cuatro patrones sobre la percepción e intención de practicar la LM: tradicional; indecisa; rechazo; e igualitarista. Conclusiones: La intención de apoyar o practicar la LM se relaciona a identidades de género y al proyecto de tener hijos y/o un proyecto de desarrollo personal-laboral. Existe convergencia entre distintas percepciones e intenciones de practicar la LM en el futuro, lo cual apunta a revisar las políticas en la materia.

Abstract: Objective: To analyze the perception and intention to practice breastfeeding (BF) in adolescents of both genders who have not yet been parents. Material and Methods: This was a qualitative study based on grounded theory with empirical saturation. Twenty-one semi-structured interviews were conducted with students between 15 and 18 years of age in preparatory schools in Monterrey, Nuevo León, Mexico. Results: Four patterns on the perception and intention of practicing breastfeeding were identified: traditional; undecided; rejection; and egalitarian. Conclusions: The intention to support or practice BF is related to gender identities and the project of having children and / or a personal- labor development project. There is convergence between different perceptions and intentions to practice BF in the future, which aims to review policies in this area.

Self-Perception of Body Weight in Schoolchildren in Northeastern Mexico.

Mexican schoolchildren are among the individuals most affected by obesity in the world. It has been observed that body-image dissatisfaction has increased in children. We evaluated their body weight perception and its relationship with actual weight; we compared this variable on three different scales according to age and sex and determined the sensitivity and specificity of these scales. This cross-sectional study was conducted with students from public and private schools in Northeastern Mexico. Boys and girls aged 6-12 years (n = 533) were included in this study. To assess the body weight perception, the following scales were used: (A) Collins (figure rating scale), (B) Eckstein (parents' perceptions of their child's weight and health scale), and (C) Truby and Paxton (children's body image scale). Agreement was evaluated using the Cohen's kappa test, determining the sensitivity and specificity. Girls and children aged 10-12 years were more likely to perceive themselves adequately (their self-perception corresponds to the figure that indicates their weight status). The children showed increased body-image distortion in the three scales. In terms of sensitivity and specificity, children with overweight or obesity were more precisely identified in scale A, whereas a healthy weight was more clearly identified in scale C.

Differences in Social Determinants of Health between Urban Indigenous Migrants and Non-Indigenous People in North-Eastern Mexico: An Analysis to Prioritize.

The degree to which social determinants of health differ between indigenous migrants and non-indigenous people born and raised locally is currently unknown. We compared social determinants of health between indigenous migrants and non-indigenous people from urban north-eastern Mexico. Additionally, we ranked priorities for addressing the negative social determinants of health. This was a population-based comparative cross-sectional study (n = 235 indigenous migrants and 168 non-indigenous people). A two-stage non-random sampling was carried out from June to August of 2019. Heads of households ≥18 years and those with the ability to communicate in Spanish were recruited house by house. Structural and intermediary determinants of health were identified according to the World Health Organization Conceptual Framework and priorities were ranked using Z-scores. Being a migrant indigenous increased 1.6 times the odds of low education (95% CI = 1.1, 2.4). In addition, the migrant indigenous status increased the odds of poor housing, unhealthy behaviour and low social cohesion (p < 0.05). Housing, behaviours and health service accessibility were top priorities for indigenous migrants and structural determinants for non-indigenous people. The findings show that the right to access the social determinants of health has not yet been guaranteed for indigenous communities.

Factors associated with abandoning exclusive breastfeeding in Mexican mothers at two private hospitals.

BACKGROUND: Exclusive breastfeeding (EBF) has multiple benefits for both the child and the mother; however, there is little data regarding the reason why Mexican mothers with a high socio-economic level abandon EBF before 6 months, and there is limited information about the practice of breastfeeding in private hospitals. The objective was to identify the factors associated with the cessation of exclusive breastfeeding in Mexican mothers at two private hospitals. METHODS: A cross-sectional study was conducted with 218 upper-class mothers selected according to their place of residence by geographic location, socio-economic level, and pediatric consultations cost. They were over 18 years old and with children aged 6 to 24 months. Data were collected between July and November 2016 by face to face interview using a structured questionnaire while the mothers waited for the pediatric postnatal care consultation in two private hospitals in northeastern Mexico. Exclusive breastfeeding was measured according to World Health Organization (WHO) recommendations, which consist of providing only breast milk for the first 6 months of life. Chi-squared tests and multivariate logistic regression were performed. RESULTS: Mean maternal age was 31.4 years (SD of 4.4) and most of the participants had an undergraduate education, were married, and worked outside the home. The prevalence of exclusive breastfeeding at 6 months was 28%. Upper-class working mothers are less likely to continue breastfeeding. There was a negative association with employment (AOR 13.69; 95% CI 1.59, 111.11), bottle use in the first 6 months (AOR 7.93; 95% CI 3.07, 20.48), and a low level of knowledge (AOR 2.18; 95% CI 1.04, 4.56). After 6 months, only 61 mothers (28%) maintained exclusive breastfeeding. CONCLUSIONS: Knowledge level, bottle use, and employment are associated with premature cessation of EBF in Mexican upper-class mothers, attending two private hospitals. There was a high percentage of breastfeeding cessation in the sample. It is necessary to reinforce a strategy that coordinates the action of the different laws, regulations and programs affecting the exclusive breastfeeding practice, in order to adequately promote breastfeeding and support mothers in both public and private sectors.

Mexican mothers' perceptions of their child's body weight.

Currently, Mexico holds one of the top rankings in childhood obesity worldwide. This present qualitative study aims to explore and describe mothers' perceptions concerning the body weight of their children and, based on these findings, be able to arrive at a typology. Research included 91 semi-structured interviews administered to mothers of children who were underweight (UW), normal weight (NW), overweight (OW) or obese (OB). The data were collected between June 2011 and December 2013. The information was analysed with MAXQDA qualitative software. It was found that overestimated perception in UW children is observed in mothers who fear gaining weight. Mothers of NW children tend to gauge the weight of their children close to that which is normal. OW children are appropriately perceived by their mothers; however, these mothers are not concerned by this situation because for them, it is something temporary that will disappear as the child grows. The majority of boys who were OB were underestimated in their weight; those who were appropriately perceived showed class II or III obesity. Mothers typically perceived OW and OB girls with greater precision. The mothers who perceived obesity in their sons or daughters felt responsible, which motivated them to change their children's habits and behaviours. Therefore, health professionals should communicate and help these mothers recognise OW and OB status in their children. Furthermore, the importance of prevention should be stressed when a child is OW, and they should be informed of the high health risks that accompany obesity.

Changing dietary habits in persons living with type 2 diabetes.

OBJECTIVE: To describe changes in eating behavior and analyze subjects' perceptions regarding a diabetes diet. METHODS: Qualitative study was conducted with 45 semistructured interviews; 21 men and 24 women who had been diagnosed with type 2 diabetes were included. Sample size was determined by theoretical sampling. Responses were grouped into codes that described concepts, themes, and subthemes. RESULTS: Three phases were identified: initial, accommodation-adaptation, and crisis. The most significant difficulties were controlling appetite increase, replacing animal fats with vegetable fats and meat with legumes and vegetables, and eating with others. CONCLUSIONS AND IMPLICATIONS: Eating behavior changes over time, with several stages, when a person lives with type 2 diabetes. Strict adherence to diet is only temporary and short-term. Further research is needed to help ill persons after they receive their first diet prescription.

Aporte calórico y macronutrimental de los menús infantiles de la comida rápida y convencional / Caloric and macronutrient contribution of the children's menu of fast and conventional food

The caloric and macronutrient contribution of the children's menu in fast food restaurants and conventional restaurants was analyzed, according to mealtimes and recommended intakes for children between 4 and 8 years old in a city in the Northeastern of Mexico with the highest childhood obesity rate in the world. This is an observational, descriptive and transversal study. The sampling was by convenience and directed when typical cases of children's menus were selected from 152 restaurants. The range of carbohydrates contribution of the children's menu varied from 53.8% to 97.9% of the recommendation; in any case the protein contribution was less than 82.2%. With regard to fats, contribution ranges were from 63% to 165.3%. These contributions increase considerably when they are analyzed by mealtimes: from 97.8% to 373.4%. In conclusion, fast food and conventional restaurants offer unhealthy meals in big portions to child population.

Se analizó el aporte calórico y de macronutrientes de me-nús infantiles en restaurantes de comida rápida y restaurantes convencionales según tiempos de comidas e ingesta recomendada para niños de 4 a 8 años en una ciudad del noreste mexicano que presenta una prevalencia de obesidad infantil de las más altas del mundo. Es un estudio observacional, descriptivo y transversal. El muestreo fue por conveniencia y dirigido al ser seleccionados casos típicos de menús infantiles de cadenas de restaurantes de mayor presencia (152 establecimientos). Los resultados muestran que el rango de aporte de hidratos de carbono varió del 53,8% a 97,9% de la recomendación; el aporte de proteína no fue menor al 82,2%; el aporte de lípidos fue de 63.0% a 165,3%. Estos aportes aumentan considerablemente al analizarlos por tiempos de comida: de 97,8% a 373,4%. Se concluye que tanto los restaurantes de comida rápida como los restaurantes convencionales ofrecen a la población infantil alimentos y porciones poco saludables.