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OBJECTIVE: To examine the association between the type of breastfeeding practiced and the quality of the sibling relationship. DESIGN: Cross-sectional study. METHOD: Participants were recruited between July and December 2019 through parenting associations and parenting support groups. They comprised a total of 149 mothers with two children between 2 and 7 years of age, who had practiced the same type of feeding with both children. Sibling relationship quality was assessed using the conflict/rivalry and warmth dimensions of the Parents' Expectations and Perceptions of Sibling Relationships with their Children (PEPC-SRQ) questionnaire. Analyses of covariance were used to identify any differences in these two dimensions of the PEPC-SRQ between the study groups (formula feeding, breastfeeding, non-prolonged breastfeeding, prolonged breastfeeding and tandem breastfeeding). RESULTS: No significant differences were observed between any of the groups regarding the conflict/rivalry dimension; in contrast, significant differences were found in the warmth dimension between the breastfeeding and formula feeding groups. CONCLUSIONS: Breastfeeding, regardless of its duration and simultaneity, was associated with higher scores in the dimension of warmth of the sibling relationship. IMPLICATIONS FOR PRACTICE: This information should be considered by healthcare professionals when providing advice on breastfeeding.

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OBJECTIVES: Previous cohort studies have found a positive association between prolonged breastfeeding (≥12 months) on dental caries, but few of them analysed the mediated effect of sugar consumption on this association. This study investigated whether prolonged breastfeeding is a risk factor for caries at 2-year follow-up assessment (21-27 months of age) and whether this effect is mediated by sugar consumption. METHODS: A birth cohort study was performed in the Brazilian Amazon (n = 800). Dental caries was assessed using the dmf-t index. Prolonged breastfeeding was the main exposure. Data on baseline covariables and sugar consumption at follow-up visits were analysed. We estimated the OR for total causal effect (TCE) and natural indirect effect (NIE) of prolonged breastfeeding on dental caries using the G-formula. RESULTS: The prevalence of caries was 22.8% (95% CI: 19.8%-25.8%). Children who were breastfed for 12-23 months (TCE = 1.13, 95% CI: 1.05-1.20) and for ≥24 months (TCE = 1.27, 95% CI: 1.14-1.40) presented a higher risk of caries at age of 2 years than those breastfed <12 months. However, this risk was slightly mediated by a decreased frequency of sugar consumption at age of 2 years only for breastfeeding from 12 to 23 months (NIE; OR = 0.95, 95% CI: 0.91-0.97). CONCLUSIONS: In this study, the effect of prolonged breastfeeding on the increased risk of dental caries was slightly mediated by sugar consumption. Early feeding practices for caries prevention and promoting breastfeeding while avoiding sugar consumption should be targeted in the first 2 years of life.

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Mexico has a high rate of cesarean sections and one of the lowest prevalences of exclusive breastfeeding in all of Latin America. There are known factors that can compensate for the disadvantages and drawbacks of cesarean delivery over breastfeeding. In terms of studying the variations of breastfeeding experiences, this work specifically concentrates on exploring different changes in the technique of cesarean section, related to immediate Skin-to-Skin Contact for women with high and low risk pregnancies, which may in turn influence Maternal Satisfaction and the choice of Prolonged Breastfeeding. A convenience sample of (n = 150) women who underwent cesarean section in a private hospital in Mexico between the years 2015-2020 participated in this study, the participants answered a structured interview protocol designed for the specific purposes of this study. The analysis was guided grounded theory. The majority of these participants (n = 121, 82.3%) were in labor before entering a cesarean section. The most common indications for cesarean section were those of active-phase arrest and regarding maternal complications, previous cesarean sections (n = 59) and hypertensive complications (n = 15) were the most frequent. For fetal complications, non-cephalic fetal positions (n = 12) were reported as the most common. Despite the different conditions of their cesarean sections, almost all the women experienced Skin-to-Skin Contact during the cesarean section. Almost all of them managed to breastfeed for more than 6 months and many of them breastfed their babies for up to 2 years. The main factors associated to prolonged breastfeeding and satisfaction were higher education degrees, immediate skin-to-skin contact during surgery and counseling on breastfeeding after the baby was born. Our findings highlight the importance of considering adjustments during and after a cesarean section, making it more focused on women and toward better probabilities of achieving prolonged breastfeeding in Mexican women. This being a first step for future studies of direct interventions in the breastfeeding process, such as the management of skin-to-skin contact and professional support after birth for guided breastfeeding.

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ResumenIntroducción. La lactancia materna es un proceso natural determinante para la supervivencia pero, ¿su prolongación podría perjudicar el desarrollo del lenguaje? El objetivo es determinar la existencia de evidencia científica sobre efectos adversos o perjudiciales de la lactancia materna o natural prolongada en el desarrollo del lenguaje en infantes de dos o más años.Métodos.Se trata de una investigación secundaria en la que se revisa literatura de las siguientes bases de datos: Annual Reviews, Clinical Key, EBSCO, EBSCOHOST, Google Académico, JAMA Network, Ovid y PubMed, hasta obtener 100 artículos. Una vez analizados y aplicados los criterios de inclusión, se seleccionó 19 documentos para dar respuesta a la pregunta PICO.Resultados.Según el diseño de los estudios, nueve de ellos presenta un nivel de evidencia II-2, ya que fueron estudios de cohortes y de estudios de casos y controles; luego, siete estuvieron constituidos por revisiones de literatura, de las cuales cuatro fueron revisiones sistemáticas; dos se califican en nivel III de evidencia pues fueron estudios descriptivos, uno mixto descriptivo y otro cualitativo y, por último, uno estuvo constituido por un ensayo clínico que corresponde al nivel de evidencia I.Conclusiones. La lactancia materna tiene un efecto positivo sobre el desarrollo del lenguaje: existe una relación causal entre duración de la lactancia y el lenguaje receptivo y la inteligencia verbal y no verbal.

AbstractIntroduction. Breastfeeding is a determinant for survival but natural process, its extension could harm the development of language? The objective is to determine the existence of scientific evidence on adverse or harmful effects of maternal or prolonged breastfeeding language development in infants of two or more years.Method. This is a secondary research literature in which the following databases are reviewed: Annual Reviews, Clinical Key, EBSCO, EBSCOHOST, Google Scholar, JAMA Network, Ovid and PubMed, to obtain 100 items. Once analyzed and applied the inclusion criteria, 19 papers were selected to answer the question PICO.Results. According to the design of the studies, nine of them present a level of evidence II-2, since they were cohort studies and case-control studies; then seven were constituted by literature reviews, of which four were systematic reviews; two are classified in level III of evidence because they were descriptive studies, a mixed descriptive and a qualitative one and, finally, one was constituted by a clinical trial that corresponds to the level of evidence I.Conclusions. Breastfeeding has a positive effect on language development: there is a causal relationship between duration of breastfeeding and receptive language and verbal and nonverbal intelligence.

ResumoIntrodução. A lactância materna é um processo natural determinante para a sobrevivência, porém, seu prologamento poderia prejudicar o desenvolvimento da linguagem? O objetivo é determinar a existência de evidência científica sobre efeitos adversos ou prejudiciais da lactância materna ou natural prolongada no desenvolvimento da linguagem em crianças de dois ou mais anos.Métodos.Trata-se de uma pesquisa secundária na que se revisa literatura das seguintes bases de dados: Annual Reviews, Clinical Key, EBSCO, EBSCOHOST, Google Acadêmico, JAMA Network, Ovid e PubMed, até obter 100 artigos. Uma vez analisados e aplicados os critérios de inclusão, se selecionaram 19 documentos para dar resposta a pergunta formulada.Resultados. De acordo com o desenho do estudo, nove deles apresenta um nível de evidência II-2, assim como os estudos de coorte e estudos de caso-controle; em seguida, sete foram constituídas por revisões de literatura, dos quais quatro eram revisões sistemáticas; tanto qualificar a nível III provas porque eram estudos descritivos, uma mista e uma qualitativa descritiva e, por fim, uma consistiu de um ensaio clínico que corresponde ao nível de evidência I.Conclusões. A lactância materna tem um efeito positivo sobre o desenvolvimento da linguagem: existe uma relação causal entre duração da lactância e a linguagem receptiva e a inteligência verbal e não verbal.

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BACKGROUND: There is scarce and conflicting evidence on medium- to long-term effects of prolonged breastfeeding on child behavior. METHOD: A population-based birth cohort study started in 2004 in the city of Pelotas, Southern Brazil. Children were followed up at 3, 12, 24, and 48 months and 6 years of age. Breastfeeding duration was determined based on information collected around the time of weaning. Psychiatric disorders were assessed using the Development and Well-Being Assessment (DAWBA). Children who were never breastfed were excluded from the analysis. Crude and adjusted analyses were performed using Poisson regression with robust variance. RESULTS: Data on breastfeeding and mental health at the age of 6 years were available for 3377 children. Prevalence of breastfeeding for 24-35 months and ≥36 months was 16.1% (95% CI: 14.8-17.3) and 8.1% (95% CI: 7.2-9.1), respectively. Prevalence of psychiatric disorders among those who were breastfed for <24 months, 24-35 months and ≥36 months was 12.4% (95% CI: 11.1-13.7), 13.1% (95% CI: 10.4-16.2) and 12.3% (95% CI: 8.7-16.8), respectively. No association was found between breastfeeding for 24 months or more and psychiatric disorders among children aged 6 years both in the crude and adjusted analyses. CONCLUSIONS: In this cohort there was no association between breastfeeding for 24 months or more and an increased prevalence of psychiatric disorders at the age of 6 years. Studies analyzing the medium- and long-term effects of prolonged breastfeeding for 2 years or more are scarce and further research is needed regarding this practice.

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The aim of the study was to explore the practice and attitudes of Saudi mothers towards breastfeeding. A cross-sectional survey done on a total of 517 Saudi mothers using a questionnaire inquiring about their demographic data, breastfeeding practice in the first 6 months after delivery and longer, different reasons for stopping breastfeeding. Furthermore, their impression on the relation between breastfeeding and breast cancer as well as prevention of infant's allergic and infectious diseases. Only 37.5% of the mothers practiced exclusive breastfeeding for 6 months. 31.9% of the mothers continued breastfeeding until 9-12 months, and only 23% continued until 18-24 months. Insufficient breast milk was the commonest reason for stopping breastfeeding (25.9%). The vast majority of the mothers (95.2%) believe that breast milk can prevent allergy and infection to their infants, and 88.4% agreed that breastfeeding may decrease the risk of breast cancer. 30% of mothers with higher income and higher socio-economic class tend to have less compliance with breastfeeding. Exclusive breastfeeding in the first 6 months lag far behind the WHO recommendation. There is a major problem with adequacy of breast milk production in the majority of mothers in this study which might indicate the need for proper awareness and teaching programs regarding breastfeeding in our community.

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OBJETIVO: Determinar los conocimientos sobre lactancia materna en madres con niñas o niños menores de 2 años, que asisten a los Centros de Salud de Taraco, Laja y Tiahuanaco, La Paz Noviembre de 2013. MATERIAL Y MÉTODOS: Estudio descriptivo observacional de serie de casos, realizado a 57 madres con niños y niñas menores de 2 años, que asisten a los Centros de Salud de Taraco, Laja y Tiahuanaco. Para recolectar los datos se aplicó una encuesta a las madres. Para el procesamiento y análisis de los datos se utilizó el paquete estadístico SPSS v 11.5. RESULTADOS: La mayoría (63%) de las madres con niños y niñas menores de 2 años conocen el tiempo que debe durar de la lactancia materna exclusiva, que es hasta los 6 meses de edad y la mitad de las madres la duración de la lactancia prolongada (51%) que es hasta los 2 años de edad. Además, la mayoría (88%) de las madres desconocen los beneficios de la lactancia materna y los beneficios del calostro (75%) para los niños y niñas. CONCLUSIONES: Si bien, la mayoría de las madres conocen el tiempo de duración de la lactancia materna exclusiva y la mitad de las madres sobre la duración de la lactancia prolongada, muchas desconocen los beneficios de la lactancia materna. Los resultados muestran que es indispensable proporcionar a las madres información sobre los beneficios, duración y técnicas de lactancia materna, para lograr prácticas de lactancia materna adecuadas que contribuyan a reducir el riesgo de morbi-mortalidad en los niños y niñas menores de dos años.

OBJECTIVE: Determine knowledge of breastfeeding in mothers with children under 2 years attending health centers of Taraco, Laja and Tiahuanaco, La Paz November 2013. MATERIAL AND METHODS: descriptive observational syudy of a series of cases, applied to 57 mothers with children under 2 years attending health centers Taraco, Laja and Tiahuanaco. To collect the data a survey was applied to mothers. For processing and analysis of data SPSS v 11.5 was used. RESULTS: Most (63%) of mothers with children under 2 years know how long it should last for exclusive breastfeeding, which is up to 6 months old and half of mothers duration of extended breastfeeding ( 51%) which is up to 2 years old. In addition, the majority (88%) of mothers know the benefits of breastfeeding and the benefits of colostrum (75%) for children. CONCLUSIONS: While most mothers know the duration of exclusive breastfeeding and half of the mothers on the duration of extended breastfeeding, many are unaware of the benefits of breastfeeding. The results show that it is essential to provide mothers with information about the benefits, duration and breastfeeding techniques to achieve adequate breastfeeding practices that help reduce the risk of morbidity and mortality in children under two years.

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