CC BY-NC-ND 4.0 · Geburtshilfe Frauenheilkd 2018; 78(06): 596-604
DOI: 10.1055/a-0601-6873
GebFra Science
Original Article/Originalarbeit
Georg Thieme Verlag KG Stuttgart · New York

Does the Degree of Acculturation Influence Breastfeeding Intention and Start or the Frequency of Early Weaning? Results of a Prospective Observational Study

Article in several languages: English | deutsch
Silke Brenne
1   Otto-von-Guericke-Universität Magdeburg, Medizinische Fakultät, Institut für Allgemeinmedizin, Magdeburg, Germany
4   Charité – Universitätsmedizin Berlin, Klinik für Gynäkologie, Campus Virchow-Klinikum, Berlin, Germany
,
Jürgen Breckenkamp
2   Universität Bielefeld, Fakultät für Gesundheitswissenschaften, AG 3 – Epidemiologie & International Public Health, Bielefeld, Germany
,
Theda Borde
3   Alice Salomon-Hochschule, Berlin
,
Matthias David*
4   Charité – Universitätsmedizin Berlin, Klinik für Gynäkologie, Campus Virchow-Klinikum, Berlin, Germany
,
Oliver Razum*
2   Universität Bielefeld, Fakultät für Gesundheitswissenschaften, AG 3 – Epidemiologie & International Public Health, Bielefeld, Germany
› Author Affiliations
Further Information

Publication History

received 26 March 2018

accepted 05 April 2018

Publication Date:
25 June 2018 (online)

Abstract

Objectives Recent breastfeeding studies from immigration countries have found that acculturation factors influence breastfeeding behaviour in women with a migration background. To date, there has been no systematic investigation for Germany. Therefore, we study whether and how the degree of acculturation within a population of migrant women influences the start, time and duration of breastfeeding.

Patient Population and Methodology Pregnant women who were admitted to one of the three participating maternity clinics in Berlin for the birth of their child in the one-year study period were surveyed (including sociodemographic details, data on migration/acculturation). These women were interviewed again two or three days post partum (including start of breastfeeding, planned breastfeeding duration, reasons for not breastfeeding). In a subgroup, a telephone interview took place 6 months post partum about the actual breastfeeding duration, contraceptive behaviour post partum and availing of midwife services following delivery. Breastfeeding behaviour was analysed using multivariate regression models, among other things.

Results The prepartum survey included 7100 women, 6884 women were contacted in the postnatal wards, and the subgroup six months after delivery comprised 605 women. No acculturation-related differences were found in the start of breastfeeding. In the adjusted model, a medium and higher degree of acculturation diminished the chance of planning a long breastfeeding period. More acculturated women show a greater risk of weaning within the first six months than less acculturated women.

Conclusion The degree of acculturation has relevant significance for some aspects of breastfeeding behaviour in women with a migration background. This should be considered both in breastfeeding promotion programmes and in further national breastfeeding studies.

* Shared last authorship


 
  • References/Literatur

  • 1 Koletzko B, Bauer CP, Cierpka M. et al. Ernährung und Bewegung von Säuglingen und stillenden Frauen. Monatsschr Kinderheilkd 2016; 164 (S5): 433-457
  • 2 Lange C, Schenk L, Bergmann R. Verbreitung, Dauer und zeitlicher Trend des Stillens in Deutschland. Bundesgesundheitsbl 2007; 50: 624-633
  • 3 von der Lippe E, Brettschneider AK, Gutsche J. et al. Einflussfaktoren auf Verbreitung und Dauer des Stillens in Deutschland. Ergebnisse der KiGGS-Studie – Erste Folgebefragung (KiGGS Welle 1). Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz 2014; 57: 849-859
  • 4 Peters E, Wehkamp KH, Felberbaum RE. et al. Breastfeeding duration is determined by only a few factors. Eur J Public Health 2005; 16: 162-167
  • 5 Rebhan B. Die prospektive Kohortenstudie „Stillverhalten in Bayern“: Analyse von Daten zur Kindergesundheit, zur Säuglingsernährung und zu Genussmittelkonsum und Rauchverhalten der Mütter [Dissertation]. München: Ludwigs-Maximilians-Universität zu München; 2008
  • 6 Rasenack R, Schneider C, Jahnz E. et al. Factors associated with the duration of breastfeeding in the Freiburg birth collective, Germany (FreiStill). Geburtsh Frauenheilk 2012; 72: 64-69
  • 7 Ahluwalia IB, DʼAngelo D, Morrow B. et al. Association between acculturation and breastfeeding among Hispanic women: data from the Pregnancy Risk Assessment and Monitoring System. J Hum Lact 2012; 28: 167-173
  • 8 Barcelona de Mendoza V, Harville E, Theall K. et al. Acculturation and intention to breastfeed among a population of predominantly Puerto Rican women. Birth 2016; 43: 78-85
  • 9 Chapman DJ, Pérez-Escamilla R. Acculturative type is associated with breastfeeding duration among low-income Latinas. Matern Child Nutr 2013; 9: 188-198
  • 10 Berry JW. Psychology of Acculturation. Understanding Individuals moving between Cultures. In: Brislin R. ed. Applied Cross-Cultural Psychology. Thousand Oaks: SAGE Publications; 1990: 232-253
  • 11 Rassin DK, Markides KS, Baranowski T. et al. Acculturation and the initiation of breastfeeding. J Clin Epidemiol 1994; 47: 739-746
  • 12 Gorman JR, Madlensky L, Jackson DJ. et al. Early postpartum breastfeeding and acculturation among Hispanic women. Birth 2007; 34: 308-315
  • 13 Schenk L, Bau AM, Borde T. et al. Mindestindikatorensatz zur Erfassung des Migrationsstatus. Empfehlungen für die epidemiologische Praxis. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2006; 49: 853-860
  • 14 Frankenberg E, Bongard S. Development and preliminary validation of the Frankfurt Acculturation Scale for Children (FRACC-C). International Journal of Intercultural Relations 2013; 37: 323-334 doi:10.1016/j.ijintrel.2012.12.003
  • 15 Abraído-Lanza AF, Chao MT, Flórez KR. Do healthy behaviors decline with greater acculturation? Implications for the Latino mortality paradox. Soc Sci Med 2005; 61: 1243-1255
  • 16 Reiss K, Breckenkamp J, Borde T. et al. Smoking during pregnancy among Turkish immigrants in Germany – are there associations with acculturation?. Nicotine Tob Res 2015; 17: 643-652
  • 17 Sussner KM, Lindsay AC, Peterson KE. The influence of acculturation on breast-feeding initiation and duration in low-income women in the US. J Biosoc Sci 2008; 40: 673-696
  • 18 Kersting M, Dulon M. Fakten zum Stillen in Deutschland. Ergebnisse der SuSe-Studie. Monatsschr Kinderheilkd 2002; 150: 1196-1201
  • 19 Chen S, Binns CW, Zhao Y. et al. Breastfeeding by Chinese mothers in Australia and China: the healthy migrant effect. J Hum Lact 2013; 29: 246-252
  • 20 Nolan A, Layte R. The ‘healthy immigrant effect’. Breastfeeding behaviour in Ireland. Eur J Public Health 2015; 25: 626-631
  • 21 Gibson-Davis CM, Brooks-Gunn J. Couplesʼ immigration status and ethnicity as determinants of breastfeeding. Am J Public Health 2006; 96: 641-646
  • 22 McGlade MS, Saha S, Dahlstrom ME. The Latina paradox: an opportunity for restructuring prenatal care delivery. Am J Public Health 2004; 94: 2062-2065
  • 23 Ro A. The longer you stay, the worse your health? A critical review of the negative acculturation theory among Asian immigrants. Int J Environ Res Public Health 2014; 11: 8038-8057
  • 24 Fox M, Thayer Z, Wadhwa PS. Assessment of acculturation in minority health research. Soc Sci Med 2017; 176: 123-132