Evidence map›Paper›PMID 33515015›Full record

ArticleThe American journal of clinical nutrition2021

Formal maternal employment is associated with lower odds of exclusive breastfeeding by 14 weeks postpartum: a cross-sectional survey in Naivasha, Kenya.

S B Ickes, V M Oddo, H K Sanders, R Nduati, D M Denno, J A Myhre, J Kinyua, L L Iannotti, B Singa, C Farquhar and 1 more

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In one paragraph

Article in The American journal of clinical nutrition, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 14 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
14citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

14 citing papers in PubMed, 1 synthesis or guideline pooled it.

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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

11 authors.

S B IckesWheaton College Department of Applied Health Science, Wheaton, IL, USA.
V M OddoUniversity of Washington Department of Health Services, Seattle, WA, USA.
H K SandersWheaton College Department of Applied Health Science, Wheaton, IL, USA.
R NduatiUniversity of Nairobi Department of Pediatrics and Child Health, Nairobi, Kenya.
D M DennoUniversity of Washington Department of Health Services, Seattle, WA, USA.
J A MyhreNaivasha Sub-County Referral Hospital and Serge East Africa, Naivasha, Kenya.
J KinyuaKenya Medical Research Institute, Nairobi, Kenya.
L L IannottiWashington University in St. Louis Brown School, St. Louis, MO, USA.
B SingaKenya Medical Research Institute, Nairobi, Kenya.
C FarquharUniversity of Washington Department of Global Health, Seattle, WA, USA.
J L WalsonUniversity of Washington Department of Global Health, Seattle, WA, USA.

Funding

Identifying risk factors for sub-optimal breastfeeding and opportunities for breastfeeding promotion among working mothers in KenyaK01TW010827 · FIC · WHEATON COLLEGE · PI ICKES, SCOTT B. · 2017 to 2021
$750k
FIC NIH HHS K01 TW010827
6 · The paper itself

Abstract

backgroundIn many low- and middle-income countries, improvements in exclusive breastfeeding (EBF) have stalled, delaying reductions in child mortality. Maternal employment is a potential barrier to EBF.

objectivesWe evaluated associations between maternal employment and breastfeeding (BF) status. We compared formally and non-formally employed mothers in Naivasha, Kenya, where commercial floriculture and hospitality industries employ many women.

methodsWe conducted a cross-sectional survey among mothers (n = 1186) from September 2018 to October 2019 at 4 postpartum time points: at hospital discharge (n = 296) and at 6 wk (n = 298), 14 wk (n = 295), and 36 wk (to estimate BF at 24 wk; n = 297) postpartum. Mothers reported their BF status and reasons for EBF cessation. We used multivariable logistic regression models to test the association between formal maternal employment and 3 outcomes: early BF initiation (within 1 h of birth), EBF at each time point, and continued BF at 9 mo. Models were informed by a directed acyclic graph: a causal diagram used to characterize the relationship among variables that influence the independent (employment) and dependent (BF status) variables.

resultsEBF did not differ by employment status at hospital discharge or at 6 wk postpartum. However, formally employed mothers were less likely than those not formally employed to report EBF at 14 wk (59.0% compared with 95.4%, respectively; AOR: 0.19; 95% CI: 0.10, 0.34) and at 24 wk (19.0% compared with 49.6%, respectively; AOR: 0.25; 95% CI: 0.14, 0.44). The prevalence of continued BF at 36 wk did not differ by group (98.1% for formally employed compared with 98.5% for non-formally employed women; AOR: 0.80; 95% CI: 0.10, 6.08). The primary reasons reported for early EBF cessation were returning to work (46.5%), introducing other foods based on the child's age (33.5%), or perceived milk insufficiency (13.7%).

conclusionsAs more women engage in formal employment in low- and middle-income countries, additional supports to help prolong the period of EBF may be beneficial for formally employed mothers and their children.

Indexed as

EmploymentAdolescentAdultBreast FeedingCross-Sectional StudiesData CollectionFemaleHumansInfantInfant, NewbornInfant Nutritional Physiological PhenomenaKenyaLogistic ModelsMultivariate AnalysisYoung Adultbreastfeedingdiet qualityinfant and young child feedinglow- and middle-income countriesmaternal employment

Identifiers

PMID33515015
PMCPMC7948888

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.