A comparison of the nutritional status and food security of drug-using and non-drug-using Hispanic women in Hartford, Connecticut.

This study compared food insecurity, nutritional status (as measured through anthropometry and dietary intake), and food preparation patterns of low-income Puerto Rican female out-of-treatment drug users with that of low-income Puerto Rican women who reported no drug use. A convenience sample of 41 drug users was compared with 41 age-matched non-drug-users from inner-city Hartford, Connecticut. A culturally appropriate food frequency questionnaire was administered and anthropometric measurements were taken. The findings suggest a high degree of poverty among all study participants, but in particular among drug users. Drug users were more likely than the controls to be food insecure (P < 0.05) and to be exposed to increasingly severe food sufficiency problems. The daily frequency of consumption of vegetables was lower (P = 0.03) for drug users than non-drug-users. Conversely, the frequency of consumption for sweets/desserts was significantly higher for drug users than the controls (P = 0.0001). Drug users, who were classified as food insecure were less likely to consume vegetables (P = 0.004) and fish (P = 0.03) than were controls who were food insecure. When comparing drug users with controls, the former group reported consuming fewer meals during a usual week than the latter group (P < 0.0001). Drug users were more likely to fry foods (P = 0.02) while the controls were more likely to bake (P = 0.005), boil (P = 0.02), and steam (P = 0.002) foods. All anthropometric measurements, except for height, were significantly lower for drug users. The results show that drug users generally maintain poorer nutritional status than non-drug-users. Nutrition interventions as part of drug treatment are needed.

Prenatal and perinatal factors associated with breast-feeding initiation among inner-city Puerto Rican women.

OBJECTIVE: To identify factors associated with the initiation of breast-feeding in a predominantly Puerto Rican population living in inner-city Hartford, Conn. DESIGN: Retrospective study of 144 Latino women (mean +/- standard deviation age = 26.3 +/- 5.7 years) with children at least 1 year old but younger than 6 years old (mean +/- standard deviation age = 3.0 +/- 1.2 years) at the time of the survey. Women were recruited from agencies sponsoring health programs for mothers and children. They were interviewed in their homes (69%) or at the Hispanic Health Council, Hartford, Conn (31%). SUBJECTS/SETTING: Low-income Latino women who had at least 1 preschooler at the time of the interview. The women lived in inner-city Hartford, and the overwhelming majority were Puerto Rican and received welfare assistance and food stamps. Seventy-eight percent of the women chose to be interviewed in Spanish; the other 22% were interviewed in English. STATISTICAL ANALYSES: Explanatory variables that related to breast-feeding initiation (P < or = .2) in bivariate chi 2 analyses were entered into a multivariate logistic regression model that was reduced using backward stepwise elimination procedures. RESULTS: Multivariate analyses indicated that breast-feeding the previous child, shorter length of maternal residence in the United States, not receiving prenatal bottle-feeding advice, more recent birth, and higher birth weight were positively associated with breast-feeding initiation. A major reason for choosing not to breast-feed was that women felt socially uncomfortable doing it. APPLICATIONS: Breast-feeding initiation was more likely in Latino women who received prenatal breast-feeding counselling and postpartum support. Mothers of low-birth-weight infants and women breast-feeding for the first time may need additional help. These findings can be used by programs like the Special Supplemental Nutrition Program for Women, Infants, and Children to increase breast-feeding initiation.

Prelacteal feeds are negatively associated with breast-feeding outcomes in Honduras.

The 1991/92 Epidemiology and Family Health Survey (ENESF) from Honduras was examined for associations between prelacteal feeds and breast-feeding outcomes. The ENESF is a self-weighted nationally representative survey that included 2380 women with children under the age of two. Multivariate logistic regression was used to examine the association between prelacteal feeds and breast-feeding practices among 0- to 6-mo-old infants (n = 714), and to identify factors associated with milk-based prelacteal feeds. Providing milk-based prelacteal feeds was negatively associated with both exclusive (odds ratio = 0.18) and any breast-feeding (0.21). Prelacteal water was negatively associated with exclusive breast-feeding (0.19). Both water- and milk-based prelacteal feeds were associated with a delayed milk arrival and a delay in the time at which the child was offered the breast for the first time. Our findings suggest that prelacteal feeds have an adverse effect on breast-feeding outcomes.

Infant bottle propping among a low-income urban population in Mexico.

The prevalence of bottle propping (permitting an infant to drink from a bottle unattended) and the determinants of this practice at 1 week and 4 months of life were studied in a selected sample of urban women in Hermosillo, Mexico. The sample (n = 165) consisted of mothers planning to breast-feed who gave birth to healthy infants at one of two public hospitals. Data were obtained by interviewing women shortly before they were discharged from the hospital and at about 1 week and 4 months postpartum. Among those mothers giving liquid breast milk substitutes to their infants, the percentage practicing bottle propping increased from 27% at 1 week (n = 20/74) to 67% at 4 months (n = 87/130). Women who practiced bottle propping at 1 week were significantly more likely to continue this practice at 4 months. Bottle propping was significantly more common, both at 1 week and 4 months, among women who had completely weaned their infants than among those who were still combining breast and formula feeding. Multivariate logistic regression indicated that 1-week risk factors for bottle propping were low socioeconomic status, being a multiparous single mother, and being a young mother (< or = 18 years old) with a female infant, while 4-month risk factors were complete weaning, delivery in a "nursery" (versus a "rooming-in") hospital, and lack of support by the mother's partner for breast-feeding. While the possible health risks associated with early bottle propping have not been well defined, the extent of the practice observed in this study suggests that such risks deserve further investigation.

Infant bottle propping among a low-income urban population in Mexico

The prevalence of bottle propping (permitting an infant to drink from a bottle unattended) and the determinants of this practice at 1 week and 4 months of life were studied in a selected sample of urban women in Hermosillo, Mexico. The sample (n = 165) consisted of mothers planning to breast-feed who gave birth to healthy infants at one of two public hospitals. Data were obtained by interviewing women shortly before they were discharged from the hospital and at about 1 week and 4 months postpartum. Among those mothers giving liquid breast milk substitutes to their infants, the percentage practicing bottle propping increased from 27 percent at 1 week ( n = 20/74) to 67 percent at 4 months (n = 87/130). Women who practiced bottle propping at 1 week were significantly more likely to continue this practice at 4 mounts. Bottle propping was significantly more common, both at 1 week and 4 months, among women who had completely weaned their infants than among those who were still combining breast and formula feeding. Multivariate logistic regression indicated that 1-week risk factors for bottle propping were low socioeconomic status, being a multiparous single mother, and being a young mother (18 years old) with a female infant, while 4-month risk factors were complete weaning, delivery in a "nursery" (versus a "rooming-in") hospital, and lack of suppport by the mother's partner for breast-feeding. While the possible health risks associated with early bottle propping have not been well defined, the extent of the practice observed in this study suggests that such risks deserve further investigation

Infant bottle propping among a low-income urban population in Mexico

The prevalence of bottle propping (permitting an infant to drink from a bottle unattended) and the determinants of this practice at 1 week and 4 months of life were studied in a selected sample of urban women in Hermosillo, Mexico. The sample (n = 165) consisted of mothers planning to breast-feed who gave birth to healthy infants at one of two public hospitals. Data were obtained by interviewing women shortly before they were discharged from the hospital and at about 1 week and 4 months postpartum. Among those mothers giving liquid breast milk substitutes to their infants, the percentage practicing bottle propping increased from 27 percent at 1 week ( n = 20/74) to 67 percent at 4 months (n = 87/130). Women who practiced bottle propping at 1 week were significantly more likely to continue this practice at 4 mounts. Bottle propping was significantly more common, both at 1 week and 4 months, among women who had completely weaned their infants than among those who were still combining breast and formula feeding. Multivariate logistic regression indicated that 1-week risk factors for bottle propping were low socioeconomic status, being a multiparous single mother, and being a young mother (18 years old) with a female infant, while 4-month risk factors were complete weaning, delivery in a "nursery" (versus a "rooming-in") hospital, and lack of suppport by the mother's partner for breast-feeding. While the possible health risks associated with early bottle propping have not been well defined, the extent of the practice observed in this study suggests that such risks deserve further investigation

This article will also be published in Spanish in the BOSP. Vol. 119, 1995

Factors associated with perceived insufficient milk in a low-income urban population in Mexico.

Survival analysis and logistic regression were used to identify factors associated with the onset of perceived insufficient milk among 165 healthy mothers who planned to breast-feed and gave birth by vaginal delivery, without complications, to a healthy term infant in either a nursery (n = 58) or a rooming-in-hospital where formula supplementation was not allowed (n = 107). Women were interviewed in the hospital and at 1 wk, 2 mo and 4 mo postpartum. Women from both hospitals were similar in socioeconomic, demographic, anthropometric, previous infant feeding experience and prenatal care variables. Eighty percent of the women reported perceived insufficient milk at some point during the study. The cue interpreted most often as indicating insufficient milk was the crying of the infant. Multivariate analyses indicated that lack of confidence in breast-feeding, delayed onset of milk production, maternal education, multiparity, sore nipples, early introduction of formula to the previous child and mother breast-fed as a child were significantly associated (P < 0.05) with perceived insufficient milk. Among women who reported perceived insufficient milk before 1 wk, breast-feeding confidence and maternal education interacted with the hospital in which they delivered.

Determinants of lactation performance across time in an urban population from Mexico.

We identified determinants of breastfeeding and full breastfeeding among 165 healthy mothers from Hermosillo, Mexico who planned to breastfeed and delivered vaginally a healthy term infant. Deliveries took place in either a nursery (n = 58) or a rooming-in (n = 107) public hospital where formula supplementation was not allowed. Multivariate analyses indicated that at 1 week full breastfeeding was associated (P < or = 0.05) with early milk arrival, social support for full breastfeeding and planned breastfeeding duration. At 2 months, full breastfeeding was associated with social support for full breastfeeding and early milk arrival. Breastfeeding was positively associated with early milk arrival and inversely associated with early introduction of supplementary bottles, maternal employment, maternal body mass index and infant age. At 4 months, full breastfeeding was positively associated with social support for full breastfeeding and inversely associated with infant age. Breastfeeding was positively associated with planned breastfeeding duration and inversely associated with early introduction of a bottle and urban background. Rooming-in mothers reported that their milk came in earlier (P < or = 0.05) than did the nursery group. Milk arrival was later when a bottle was introduced in the first week; both of these variables might be important in explaining a positive effect of rooming-in on lactation performance.

Effect of the maternity ward system on the lactation success of low-income urban Mexican women.

We compared the lactation performance of 165 healthy mothers who planned to breastfeed and gave birth by vaginal delivery, without complications to a healthy infant in either a nursery (NUR) (n = 58) or a rooming-in hospital where formula supplementation was not allowed. In the rooming-in hospital, women were randomly assigned to a group that received breastfeeding guidance during the hospital stay (RIBFG) (n = 53) or to a control group (RI) (n = 54). Women were interviewed in the hospital and at 8, 70 and 135 days post-partum (pp). The groups were similar in socio-economic, demographic, anthropometric, previous breastfeeding experience and prenatal care variables. Non-parametric survival analyses adjusting for potential confounding factors show that breastfeeding guidance had a positive impact (P < or = 0.05) on breastfeeding duration among primiparous women who delivered in the rooming-in hospital. Among primiparae, the RI and RIBFG groups had higher (P < or = 0.05) full breastfeeding rates than the NUR group in the short term. In the longer term, only the difference between the RIBFG and the NUR group remained statistically significant. The maternity ward system did not have a statistically significant effect on the lactation performance of multiparae.