Title

The Contexts of Life Course Health Development Associated with Exclusive Breastfeeding in the United States

Location

Room C

Start Time

19-10-2013 9:00 AM

End Time

19-10-2013 9:30 AM

Session Type

Research Paper

Abstract

Breastfeeding is a highly interactive occupation, or co-occupation, in which the mother and infant engage in a synchronous interplay. Previously, breastfeeding was recognized as an essential co-occupation vital to growth and development characterized most strongly by shared physicality and less so by shared emotionality and shared intentionality (Pickens & Pizur-Barnekow, 2009; Pierce, 2009). However, occupations such as breastfeeding are health producing and recognition of the life course health that arises from co-occupational shared emotionality and shared intentionality is important. Public health literature has called for application of a life course perspective to research, program development, and policy, with the goal of identifying early life experiences associated with health disparities across the life course (Halfon & Hotchstein, 2002). Occupational science offers the opportunity for deeper examination of the shared meaning of early co-occupational engagement such as exclusive breastfeeding for life course health. The World Health Organization and American Academy of Pediatrics recommend exclusive breastfeeding for the first 4 to 6 months of life (WHO, 1998; AAP, 2012). Healthy People 2020 established an objective that 25% of infants be exclusively breastfed for the first 6 months. However, this is a challenge in the United States, given 75% of women in the United States initiated breastfeeding in 2006, but only 14% achieved exclusive breastfeeding for the duration of 6 months (USDHHS, 2010). The purpose of this study was to describe the characteristics of women who exclusively breastfed for at least 4 months, compare the characteristics of those women with a group of women who initiated exclusive breastfeeding but did not meet the desired outcome, and to identify those factors that predict exclusive breastfeeding for at least 4 months. This study used secondary analysis of data from the Infant Feeding Practices Study II to examine two cohorts: the cohort of women who reported exclusively breastfeeding at the time of hospital discharge (n=1226) and a sub-cohort of women who returned to work at month 3 after giving birth (n=421). The Life Course Health Development framework was used to organize independent factors into five contexts for analysis and interpretation of results: social, culture, and policy, health care system, family, physical, and psychological context (Halfon & Hotchstein, 2002). Independent factors consisted of socio-demographic characteristics, risk of postpartum depression, and work and child care characteristics. Results of bivariate and multivariate analysis showed that college education, marriage, and flexible work characteristics were associated with the likelihood of exclusive breastfeeding for at least 4 months, whereas the plan to return to work after birth and risk of postpartum depression were significant risk factors for not achieving this outcome. Results of this study demonstrate the usefulness of the LCHD framework for examining factors associated with exclusive breastfeeding and analyzing complex co-occupations. The findings also inform national and local policy decisions regarding family medical leave, social welfare, and other areas of family policy.

Objectives

1. Describe the health benefits of occupational engagement in breastfeeding and discuss recommendations for exclusive breastfeeding duration.

2. Analyze the contexts associated with exclusive breastfeeding for recommended durations.

3. Use the Life Course Health Development framework to examine occupational engagement in breastfeeding.

References

American Academy of Pediatrics, Section on Breastfeeding. (2012). Breastfeeding and the use of human milk. Pediatrics, 129, e827-e841. doi:10.1542/peds.2011-3552

Halfon, N. & Hochstein, M. (2002). Life course health development: An integrated framework for developing health, policy, and research. The Milbank Quarterly, 80(3), 433-479.

Pickens, N. D. & Pizur-Barnekow, K. (2009). Co-occupation: Extending the dialogue. Journal of Occupational Science, 16(3), 151-156. doi: 10.1080/14427591.2009.9686656

Pierce, D. (2009). Co-occupation: The challenges of defining concepts original to occupational science. Journal of Occupational Science, 16(3), 203-207. doi: 10.1080/14427591.2009.9686663

United States Department of Health and Human Services. (2010). Women’s Health USA 2010. Retrieved from http://mchb.hrsa.gov/whusa10/pdfs/w10.pdf

This document is currently not available here.

Share

COinS
 
Oct 19th, 9:00 AM Oct 19th, 9:30 AM

The Contexts of Life Course Health Development Associated with Exclusive Breastfeeding in the United States

Room C

Breastfeeding is a highly interactive occupation, or co-occupation, in which the mother and infant engage in a synchronous interplay. Previously, breastfeeding was recognized as an essential co-occupation vital to growth and development characterized most strongly by shared physicality and less so by shared emotionality and shared intentionality (Pickens & Pizur-Barnekow, 2009; Pierce, 2009). However, occupations such as breastfeeding are health producing and recognition of the life course health that arises from co-occupational shared emotionality and shared intentionality is important. Public health literature has called for application of a life course perspective to research, program development, and policy, with the goal of identifying early life experiences associated with health disparities across the life course (Halfon & Hotchstein, 2002). Occupational science offers the opportunity for deeper examination of the shared meaning of early co-occupational engagement such as exclusive breastfeeding for life course health. The World Health Organization and American Academy of Pediatrics recommend exclusive breastfeeding for the first 4 to 6 months of life (WHO, 1998; AAP, 2012). Healthy People 2020 established an objective that 25% of infants be exclusively breastfed for the first 6 months. However, this is a challenge in the United States, given 75% of women in the United States initiated breastfeeding in 2006, but only 14% achieved exclusive breastfeeding for the duration of 6 months (USDHHS, 2010). The purpose of this study was to describe the characteristics of women who exclusively breastfed for at least 4 months, compare the characteristics of those women with a group of women who initiated exclusive breastfeeding but did not meet the desired outcome, and to identify those factors that predict exclusive breastfeeding for at least 4 months. This study used secondary analysis of data from the Infant Feeding Practices Study II to examine two cohorts: the cohort of women who reported exclusively breastfeeding at the time of hospital discharge (n=1226) and a sub-cohort of women who returned to work at month 3 after giving birth (n=421). The Life Course Health Development framework was used to organize independent factors into five contexts for analysis and interpretation of results: social, culture, and policy, health care system, family, physical, and psychological context (Halfon & Hotchstein, 2002). Independent factors consisted of socio-demographic characteristics, risk of postpartum depression, and work and child care characteristics. Results of bivariate and multivariate analysis showed that college education, marriage, and flexible work characteristics were associated with the likelihood of exclusive breastfeeding for at least 4 months, whereas the plan to return to work after birth and risk of postpartum depression were significant risk factors for not achieving this outcome. Results of this study demonstrate the usefulness of the LCHD framework for examining factors associated with exclusive breastfeeding and analyzing complex co-occupations. The findings also inform national and local policy decisions regarding family medical leave, social welfare, and other areas of family policy.

Objectives

1. Describe the health benefits of occupational engagement in breastfeeding and discuss recommendations for exclusive breastfeeding duration.

2. Analyze the contexts associated with exclusive breastfeeding for recommended durations.

3. Use the Life Course Health Development framework to examine occupational engagement in breastfeeding.