Cross-generational effect of food insecurity: Understanding the relationship between food insecurity and breastfeeding behaviors.

项目摘要 美国儿科学会建议婴儿出生后前6个月进行纯母乳喂养。 母乳在短期和后期都能保护婴儿免受传染病和慢性疾病的侵袭。 特别是，母乳喂养确保了婴儿的安全和最佳营养。然而，母乳喂养率是 在低收入女性中较低。 我们目前对低收入人群(主要是非裔美国人和西班牙裔母亲)进行的R15研究的初步结果， 90%的人开始母乳喂养，但只有24%的人在婴儿2个月时开始纯母乳喂养 年龄。在估计风险因素时，研究发现，食物不安全的母亲母乳喂养的可能性要低1.5倍 在控制了社会人口变量后，2个月与安全的同龄人进行了比较。因此， 基于社会认知理论，这项R15更新研究的总体目标是描述如何 粮食不安全往往涉及间歇性粮食短缺，会影响母乳喂养的压力水平和频率。 我们假设，在粮食缺乏保障的家庭中，不稳定的家庭食品供应会导致供应中断。 纯母乳喂养1)压力增加，2)哺乳或吸奶不规范。 最终，不规律的母乳喂养会导致乳房退缩或乳腺开始收缩 回到不产奶的状态，导致产奶量减少，母乳喂养自我效能低下， 并最终停止母乳喂养。 为了解决我们的假设，我们提出的4个具体目标是：确定 产后食物不安全，表现为家庭食物供应不一致和--1)母乳皮质醇水平； 2)母乳喂养方式；3)乳腺开始退化或收缩至不产奶 状态；4)母乳喂养自我效能。在这项研究中，将对45名低收入者进行每周6次的家访 在医院开始母乳喂养的母亲。每周的家访将从3到4天开始 出院后。在每次家访时，都会对家庭食物进行清点，并采集母乳样本 将收集用于测量皮质醇(应激)和乳腺退化的生物标志物。在每次访问期间， 我们还将采访母亲，以评估母乳喂养或吸奶的频率。自我哺乳 疗效和社会支持也将被衡量。 这项研究的结果将为粮食不安全之间的关系提供重要的新数据 母乳喂养。此外，此次R15续订将帮助我们继续为第一代产品提供研究培训 和传统上代表不足的学生。

Project Summary The American Academy of Pediatrics recommend exclusive breastfeeding for the first 6 months of life. Breastmilk protects infants from infectious and chronic diseases both in the short term and later in life. Especially, breastfeeding ensures security and optimal nutrition for infants. However, breastfeeding rates are lower among low-income women. Preliminary results of our current R15 study with low-income, mainly African American and Hispanic mothers, indicated that 90% initiated breastfeeding, but only 24% were exclusively breastfeeding at 2 months of infant’s age. In estimating risk factors, it was found that food-insecure mothers were 1.5 times less likely to breastfed at 2 months compare to their secure counterparts after controlling for socio-demographic variables. Hence, grounded in Social Cognitive Theory, the overall goal of this R15 renewal study is to characterize how food insecurity often involving intermittent food shortage affects stress levels and frequency of breastfeeding. We hypothesize that in food-insecure households, an inconsistent home food supply causes discontinuation of exclusive breastfeeding through 1) increased stress, and 2) irregularity in nursing or breast pumping. Ultimately, irregular breastfeeding leads to onset of involution or begin of constriction of mammary glands to return to a non-milk-producing state, contributing to decreased milk production, low breastfeeding self-efficacy, and ultimately discontinuation of breastfeeding. To address our hypothesis, the 4 specific aims we propose are: Determine associations between postpartum food insecurity in the form of inconsistency in home food supply and-- 1) breastmilk cortisol levels; 2) breast milk feeding pattern; 3) onset of involution or constriction of mammary glands to a non-milk producing state; 4) breastfeeding self-efficacy. For the study, 6 weekly home visits will be conducted with 45 low-income mothers who initiated breastfeeding at the hospital. The weekly home visits will occur starting from 3 to 4 days after hospital discharge. At each home visit, home food inventory will be conducted, and breastmilk samples will be collected to measure cortisol (stress) and biomarkers of mammary gland involution. During each visit, we will also interview mothers to assess frequency of breastmilk feeding or pumping. Breastfeeding self- efficacy and social support will also be measured. The results of this study will provide important new data on the relationship between food insecurity breastfeeding. Further, this R15 renewal will help us continue providing research training to first-generation and traditionally underrepresented students.