Stillbirth in Iran and associated factors (2014-2016): A population-based study.

Background: Under Every Newborn Action Plan (ENAP), stillbirth rate in every country should be reduced by 12 or fewer per 1000 total births by 2030. The aims of this study were to determine stillbirth rate at national and subnational levels and to investigate its associated risk factors in Iran. Methods: Using all data from Iranian Maternal and Neonatal Network (IMaN), we calculated stillbirth rate of Iran from 2014-2016. This network registers information of almost all births across the country. The logistic regression was used to estimate the adjusted odds ratio (aOR) with 95% confidence intervals (CIs) for stillbirth. Results: In 2014, still birth rate was 7.40 per 1000 births. In 2015 and 2016, stillbirth rates were 7.22 per 1000 births and 7.63 per 1000 births, respectively. The most important related factors of stillbirth were preterm birth (aOR= 62.53, 95% CI; 60.77-64.34), sexual ambiguity (aOR= 14.51, 95% CI; 12.76-16.50), and post term birth (aOR= 3.31, 95% CI; 2.66-4.13). Conclusion: Under Every Newborn Action Plan (ENAP), stillbirth rate in every country should be reduced by 12 or fewer per 1000 total births by 2030. Iran has achieved stillbirth target of ENAP at national level. It is important for the health care system to establish and improve specific and focused policies, interventions, and programs for achieving this target even in the most deprived areas.

Frequency of "Nursing Strike" among 6-Month-Old Infants, at East Tehran Health Center and Contributing Factors.

OBJECTIVE: An abrupt refusal by the infant to breastfeed is often called "nursing strike". In fact a common reason for cessation of nursing is infant's refusal to breast feed. This problem can often be overcome. This paper has aimed to identify the causes of "breast feeding refusal" or "nursing strike" in 6 month old infants visiting the East Tehran health center for their scheduled vaccination of 6 months old. MATERIALS AND METHODS: Totally 175 six month old infants were enrolled in this study. A questionnaire was filled by mother for each child and later the infants with "nursing strike" were compared with all others. RESULTS: In this study prevalence of breast feeding refusal in infants was 24%.There was significant relation between the "breastfeeding refusal" and maternal academic education or working status. In this study mothers reported various reasons associated with "refusal breast feeding. According to the mothers playful infant and nasal obstructions were the probable causes for refusal. CONCLUSION: There is a diverse variety of factors influencing nursing strike. Most of these factors can be prevented by identifying the background reasons and proper training.

A single center study of the effects of trained fathers' participation in constant breastfeeding.

Constant breastfeeding that depends on the family support. Fathers' involvement is as an important factor of successful breastfeeding. The aim of this study was to evaluate the influence of fathers' participation in constant breastfeeding in Vali-E-Asr Hospital, Tehran, Iran. This interventional study was piloted on spouses of pregnant women participating in pregnancy courses. The case group consisted of fathers attending training courses of breastfeeding during pregnancy (Group A), and the control group was made up of fathers who did not take part in training courses (Group B). The courses were held three times from the 30th week of gestation to the end of pregnancy in a family health research center. Fathers attended three training sessions where they were trained by brochures. After delivery newborns were weighted and examined for jaundice (3-5 days, 30 days, three and six months after birth). According to mothers' views, spouses' participation, encouragement and support in group A, was 11 times more than group B. It means that 47 (94%) of spouses in the group A participated in mothers' constant breastfeeding, but fathers' participation in group B was 60% (30 spouses). This study showed that breastfeeding was more constant in the group that fathers participated in breastfeeding training course. One of the reasons for such a significant difference was spouses' participation, encouragement and support in the trained group. This study showed that fathers' involvement in training programs may influence constancy of breastfeeding.

Frequency of exclusive breastfeeding and its affecting factors in Tehran, 2011.

This study was designed to assess the frequency of exclusive breastfeeding in two health centers of Shahid Beheshti University of Medical sciences in Khak Sefid, Tehran, Iran. A total of 175 mothers, referred for the third dose of their infants' DPT vaccination program participated in the study by completing a questionnaire regarding characteristics of their pregnancy, delivery and exclusive breastfeeding within the first six months of birth. Two-variable analysis and logistic regression test were applied to evaluate factors influencing exclusive breastfeeding. Results indicated that the frequency of exclusive breastfeeding, i.e., breastfeeding within the first six months of birth without the use of any other food with or without vitamin supplementation, was 31.17% (95% CI=23.77%-38.57%), which means 48 infants of 154<179 days old Among 154 infants (<179 days old) 48 did not have a history of being separated from their mothers. In logistic regression analysis, the variables which were directly associated with exclusive breastfeeding, with 0.05 significance level of alpha, included breastfeeding within the first hour of birth, eight times or more breastfeeding per day and receiving breastfeeding education during pregnancy. Variables with a negative association with breastfeeding included lack of breast milk, presence of a breast problem that could hinder breastfeeding, bottle feeding, physician or family's advice not to breastfeed and infant's refusal to breastfeed. Frequency of breastfeeding within the six months of birth is less than similar frequencies which are obtained by asking about breastfeeding on the day of the interview. It is recommended to apply real frequency for assessment, evaluation and programming of exclusive breastfeeding during the first six months of birth.