Association between breastfeeding and child stunting in Mexico

Background: Globally, the prevalence of child stunting has been decreasing over the past decades. How-ever, in low-and middle-income countries such as Mexico, stunting is still the most prevalent form of undernutrition affecting a large number of children in the most vulnerable conditions. Breastfeeding has been identified as one of the key affordable and modifiable maternal health behaviors protecting against child stunting. Objective: To examine the association between breastfeeding (defined as never breastfed, any breast-feeding for \u3c6 months, and any breastfeeding for ≥6 months) and other individual-, household-, and area-level factors with child stunting (defined as length/height-for-age-z-score for sex under –2 standard deviations of the World Health Organization child growth standards’ median) in Mexico. Methods: Secondary data analysis using the 2012 Mexican Health and Nutrition Survey, which allowed representativeness of rural and urban areas at national level and among 4 regions in Mexico. Our subset included data on 2,089 singleton Mexican children aged 6–35 months with information on previously identified risk and protective factors for stunting. We conducted fixed-and mixed-effects logistic regression models sequentially controlling for each level of factors. Findings: Overall, 12.3% of children were stunted and 71.1% were breastfed for ≥6 months. Any breast-feeding and being female were consistent protective factors against child stunting across all models. In contrast, child low birthweight, maternal short stature, higher number of children aged \u3c5 years per household, and moderate to severe food insecurity were consistent risk factors for child stunting across all models. Conclusions: According to our findings, efforts to reduce child stunting in Mexico should include prenatal strategies aiming to prevent low birthweight offspring particularly among short-stature women, moderate to severe food insecure households, families with a higher number of children aged \u3c5 years, and indigenous communities. Postnatal components should include multilevel strategies to support breastfeeding

Obesity in preschool children : an analysis of policy-relevant risk factors

EThOS - Electronic Theses Online ServiceGBUnited Kingdo

The Impact of Sex of Child on Breastfeeding in the United States

Background: Sex of child has been shown to impact breastfeeding duration in India, Australia, Scandinavia, Latin America, and, within the US, in a sample in Eastern Connecticut and in a separate sample of Indian and Chinese immigrants. Objectives: The objective of this study is to examine differences in breastfeeding initiation and duration by sex of child across racial/ethnic groups in the US. Methods: We used the Pregnancy Risk Assessment Monitoring System 2009-2010 and logistic regression to examine whether sex of child impacts breastfeeding initiation and duration for at least 8 weeks by women\u27s racial/ethnic group. Results Among the 66,107 women in our sample representing 12 different race/ethnic groups, Hispanic women (n = 9049) had lower odds of breastfeeding initiation (adjusted odds ratio [AOR] = 0.81, 95% CI 0.71-0.93) and breastfeeding duration (AOR = .87, 95% CI 0.80-0.96) if they have sons compared to Hispanic women who have daughters. Sex of child did not impact the odds of breastfeeding initiation or duration among any other race/ethnic group. Conclusion: We have shown that, for Hispanics in the US, sex of child may have an impact on breastfeeding, a health behavior that has a variety of positive impacts on infants throughout their lives. Boys, relative to girls, were at a disadvantage in breastfeeding initiation and duration. Future work is necessary to unpack the mechanisms behind these findings. In particular, how sex of child impacts how mothers and fathers view the nutritional needs of their children and breastfeeding more broadly

Lifecourse influences on women's smoking before, during and after pregnancy

The concept of the socioeconomic lifecourse is increasingly informing understanding of the social patterning of cigarette smoking. We investigated lifecourse influences on (i) women's smoking status (smoker/non-smoker) before pregnancy and (ii) quitting in pregnancy in the UK Millennium Cohort study. Our analyses included conventional measures of the socioeconomic lifecourse (woman's childhood circumstances, education, current socioeconomic circumstances) and measures of her domestic lifecourse (age of becoming a mother, current cohabitation status), as well as parity (first/subsequent child). In analyses of quitting, we also included pre-pregnancy cigarette consumption. Our study underlined, firstly, the importance of lifecourse disadvantage. Those experiencing greater disadvantage with respect to their childhood circumstances, education and current circumstances were at greater risk of being a smoker before pregnancy. A disadvantaged domestic lifecourse - earlier entry into motherhood and lone motherhood-further increased the risk. Poorer childhood circumstances, educational disadvantage, poorer current circumstances and early motherhood also significantly increased the odds of quitting in pregnancy. Secondly, parity was a major predictor of smoking behaviour. First-time mothers had higher odds both of smoking before pregnancy and quitting in pregnancy. The effects of parity were independent of women's lifecourse. Our study supports tobacco control policies which recognise and address inequalities across the lifecourse. However, our study suggests that the dye is not irrevocably cast by social disadvantage: first pregnancy uniformly increases the chances of quitting. Interventions which help smokers having their first baby to quit have an important part to play in promoting maternal and child health.Cigarette smoking Lifecourse Women Pregnancy Quitting UK Disadvantage

Associations between e-cigarette policies and adolescent use and access to e-cigarettes

Background: Tobacco control policies have been adapted to address rising levels of adolescent e-cigarette use. Despite new restrictions, adolescents are continuing to access e-cigarettes. Methods: We linked 2015–2019 Youth Risk Behavior Survey data on 503,154 14–18-year-olds from 40 states with state-level e-cigarette minimum legal sales age (MLSA) laws, taxes, and smoke-free legislation. Using two-way fixed effects probit regression models, we first examined the associations between these statewide e-cigarette policies and adolescent use and, second, with access to e-cigarettes. We subsequently tested interactions between age and each policy and present average marginal effects as percentage point (pp) changes. Results: While MLSA laws for e-cigarettes were associated with slight increases in e-cigarette use (2.72 pp; 1.29, 4.15), associations were no longer significant after at least 1-year post-implementation. MLSA laws were also associated with decreases in e-cigarette purchases in stores (-9.50 pp; -18.21, -0.79) and increases in acquiring them from someone else (13.26 pp; 4.10, 22.42), particularly among 18-year-olds. E-cigarette taxes were associated with decreases in use (-9.18 pp; -11.63, -6.73), but there were limited associations with e-cigarette access. While smoke-free legislation prohibiting e-cigarettes was associated with slight increases in use (1.87 pp; 0.23, 3.50), after at least 1-year post-implementation, they were associated with decreases in use. Smoke-free legislation was also associated with decreases in purchases in stores by 14-year-olds, but increases in online purchases by 18-year-olds. Conclusion: Understanding the immediate and longer-term consequences of e-cigarette policies is essential to influence adolescent e-cigarette use. Adolescents will continue acquiring e-cigarettes across varying sources if measures are not taken to address access alongside policies aimed at reducing use

Impact of tobacco control policies on adolescent smokeless tobacco and cigar use: a difference-in-differences approach

Abstract Background While increasing cigarette taxes has been a major policy driver to decrease smoking, taxes on other tobacco products have received less attention. Our aims were to evaluate the impact of chewing tobacco/cigar taxes, cigarette taxes, and smoke-free legislation on adolescent male and female use of smokeless tobacco and cigars. Methods We analyzed data on 499,381 adolescents age 14-18 years from 36 US states in the Youth Risk Behavior Surveys (1999-2013) linked to state-level tobacco control policies. We conducted difference-in-differences regression models to assess whether changes in taxes and the enactment of smoke-free legislation were associated with smokeless tobacco use and, separately, cigar use. Models were stratified by adolescent sex. Results We found that chewing tobacco taxes had no effect on smokeless tobacco use and cigar taxes had no effect on cigar use. In contrast, among males a 10% increase in cigarette taxes was associated with a 1.0 percentage point increase (0.0010, 95% CI 0.0003-0.0017) in smokeless tobacco use. A 10% increase in cigarette taxes was also associated with a 1.5 percentage point increase (0.0015, 95% CI 0.0006-0.0024) in cigar use among males and a 0.7 percentage point increase (0.0007, 95% CI 0.0001-0.0013) in cigar use among females. There was some evidence that smoke-free legislation was associated with an 1.1 percentage point increase (0.0105, 95% CI 0.0015-0.0194) in smokeless tobacco use among males only, but no effect of smoke-free legislation on cigar use for males or females. Conclusions Higher state cigarette taxes are associated with adolescents’ use of cheaper, alternative tobacco products such as smokeless tobacco and cigars. Reducing tobacco use will require comprehensive tobacco control policies that are applied equally to and inclusive of all tobacco products

Perceived and objective measures of the neighbourhood environment and overweight in preschool children and their mothers

Objectives. The primary aim was to examine the relationships between perceived and objective measures of the neighbourhood environment, measured in late infancy, and subsequent overweight (including obesity) in 3-year-old children and their mothers. The secondary aim was to assess whether moving residence confounded these relationships. Methods. We analysed data on 8 154 children and their mothers from the UK Millennium Cohort Study who had participated since birth and were living in England. At the first contact (late infancy), mothers reported their perceptions of their neighbourhood environment, and objective measures of the neighbourhood environment were obtained by linking national deprivation data to each child's postcode. We conducted logistic and multilevel regression analyses to examine perceived and objective measures of the neighbourhood environment, respectively, and overweight at the second contact (3 years) in children and their mothers. All analyses were adjusted for moving residence. Results. There were few consistent patterns between measures of the neighbourhood environment (perceived or objective) and early childhood overweight. However, mothers’ risk of overweight increased with increasingly poor neighbourhood conditions (perceived) or residence in areas of increasing deprivation (objective), after adjustment for individual socio-demographic factors. All relationships were maintained after adjustment for moving residence. Conclusions. While area-level factors have limited influence on the development of overweight in preschool children, they are likely to affect overweight in their mothers. Policies need to address both individual and environmental factors to tackle obesity and its determinants across the life course