Understanding Breastfeeding Practices Among ECHO Cohort Participants Before and During/After the COVID-19 Pandemic

项目摘要 纯母乳喂养被广泛推荐，因为它提供了重要的孕产妇和儿童健康 这些益处包括预防肥胖和传染病。虽然许多妇女打算母乳喂养， 他们往往达不到自己的目标。这可能是由于生理条件，如肥胖，或由于 新冠肺炎疫情等公共卫生危机以及我们社会中潜在的系统性不平等。因此 重要的是要解决高度流行的暴露，包括产妇肥胖和当代的影响， 包括COVID-19大流行在内的情况对母乳喂养开始和持续时间的围产期结果的影响 以及包括肥胖症在内的儿童健康结果。肥胖，母乳喂养时间缩短，以及 SARS-CoV-2感染对黑人家庭的影响不成比例。因此，任何试图解决这些问题的努力 重要的问题也将有助于消除现有的健康差距。这项研究的目的是双重的。 首先，使用来自多个ECHO队列的数据，我们的目标是确定纯母乳喂养的持续时间 保护那些在子宫内暴露于母体肥胖的儿童免受儿童肥胖的风险。第二、 我们将从定量和定性两个方面评估SARS-CoV-2大流行对妇女的影响， 母乳喂养的实践和经验。定量和定性方法的结合将 使人们能够更全面地了解母乳喂养的决定因素， 流行病作为UH3OD 023285产前暴露和儿童健康结局的补充：全州范围内 研究，该项目补充了父母补助金的目标2，即评估母亲营养的影响， 和体重状况对认知结果和儿童肥胖的影响。父母补助金的重点是 怀孕期间的营养，而该项目的重点是婴儿营养。此外，该项目将 为博士后候选人提供重要的培训，因为她准备成为一名教师， 研究型大学。她将利用该项目继续开展围产期和 儿科流行病学研究设计和分析方法。虽然这项研究将利用当地的 ECHO队列，该项目旨在通过两种不同但互补的方式参与ECHO团队科学 ECHO范围内的分析概念提案。该项目意义重大，因为它解决了三个高度流行的问题， 不成比例地使黑人家庭处于不利地位的问题：母乳喂养时间缩短，SARS-CoV- 2感染和肥胖。

PROJECT SUMMARY Exclusive breastfeeding is widely recommended because it provides important maternal and child health benefits including protection against obesity and infectious disease. While many women intend to breastfeed, they often fail to reach their goal. This could be due to physiological conditions, such as obesity, or due to public health crises like the COVID-19 pandemic and the underlying systemic inequities in our society. Thus, it is important to address the impact of highly prevalent exposures including maternal obesity and contemporary situations including the COVID-19 pandemic on the perinatal outcomes of breastfeeding initiation and duration as well as on child health outcomes including obesity. Obesity, shortened duration of breastfeeding, and SARS-CoV-2 infection all disproportionately impact black families. Therefore, any attempts to address these important issues will also help to eliminate existing health disparities. The purpose of this research is twofold. First, using data from multiple ECHO cohorts, we aim to determine if the duration of exclusive breastfeeding protects against risk for childhood obesity among those exposed to maternal obesity while in utero. Second, we will estimate, both quantitatively and qualitatively, the impact of the SARS-CoV-2 pandemic on women's breastfeeding practices and experiences. The combination of quantitative and qualitative approaches will enable a more comprehensive understanding of the determinants of breastfeeding before and during/after the pandemic. As a supplement to UH3OD023285 Prenatal Exposures and Child Health Outcomes: A Statewide Study, this project complements Aim 2 of the parent grant, which is to assess the effect of maternal nutritional and weight status in pregnancy on cognitive outcomes and childhood obesity. The parent grant is focused on nutrition during pregnancy whereas this project is focused on infant nutrition. Furthermore, this project will provide important training for a postdoctoral candidate as she prepares to become a faculty member at a research-intensive university. She will use this project to continue to develop specific training in perinatal and pediatric epidemiological research design and analytic methods. While this research will leverage the local ECHO cohort, the project is designed to engage ECHO team science through two distinct but complementary ECHO-wide analysis concept proposals. The project is significant because it addresses three highly prevalent problems that disproportionately disadvantage black families: shortened duration of breastfeeding, SARS-CoV- 2 infection, and obesity.