• Asian Journal for Public Opinion Research
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• v.4 no.4
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• pp.208-245
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• 2017

Background: Attitudes toward breastfeeding in public are one potential barrier to optimal breastfeeding rates and durations. Method: Questions about breastfeeding experience and attitudes toward breastfeeding in public were asked in face-to-face interviews as part of the Korean Academic Multimode Open Survey (KAMOS), May-July, 2017. The response rate was 65.8% (2000 respondents nationwide). Results: A majority of Koreans disagreed (1 or 2 on a 4-point scale) with the statement "Women should not breastfeed their child in open, public places" (53.9%) and agreed (3 or 4 on the 4-part Likert scale) with the statements "I do not feel uncomfortable seeing women breastfeed their child in open, public places" (64.0%) and "Breastfeeding a baby, instead of letting the baby cry, in public places is better for other people" (71.8%). However, despite these generally positive attitudes, the majority also said that they would not breastfeed in public (57.4% of women) or, in the case of men, would not want a close female relative to do so (63.8% of men). Breastfeeding in public was positively correlated with the duration of breastfeeding. People were more positive about breastfeeding in public if they: were parents; did not use formula and breastfeeding a similar amount; had children who had been breastfed in public; were older; were Buddhists rather than Christians. An attempt was made to compare attitudes toward breastfeeding in public and breastfeeding durations internationally, but was inconclusive due to not perfectly comparable data. Conclusion: Our results may be useful in planning public health campaigns in South Korea or future attempts at international comparisons to better understand and address the effect of public opinion regarding breastfeeding in public on breastfeeding rates and durations.

• Korean Journal of Community Nutrition
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• v.1 no.3
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• pp.335-345
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• 1996

The solids(supplementary food) consumption of 200 healthy infants aged from 4 to 6 months have been measured. Five groups were assigned to different feeding patterns. Breastfed group(BF, n=38), formula-fed group(FF, n=102) and mixed-fed group(MF, n=14) were fed breast milk, formula and mixed(breast mile+formula) from birth until 6 months of age respectively. Convert 1 group(C1F, n=14) and convert 2 group(C2F, n=32) were fed breast milk and mixed milk at 2 months of age respectively and were switched to formula thereafter. All infants received solids form 4 months of age. The energy intake from solids at 4 and 6 months averaged 59.1 and 110.3㎉/d among BF groups vs 151.9 and 239.3㎉/d among FF groups respectively. Intakes of protein, calcium and iron were 38-46$\%$, 34-44% and 25-37$\%$ higher in the FF than in the Bf group during the first 6 months. However, no significant differences were found in the intakes of energy and nutrient intakes from solids in all 4 groups excluding BF group(39$\%$). Although BF infant's nutrient intakes from solids were lower than other group's intakes, they intaked evenly solids from various food groups. As the age of infant had increased, the energy intake ratio from solids was cereals and dairy products was increased whereas energy intake ratio from meats, eggs, fruits and vegetables was decreased. TSC4, TSC6(the frequency score for the kinds of weaning food taken) showed no significant difference among 5 feeding groups but CIF-and C2F group's scores tended to be high. Consequently, these results suggest that BF group's solid intake pattern is more desirable and that Korean lactating Mother's dependence on commercial weaning food is too high.

• Women's Health Nursing
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• v.23 no.4
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• pp.233-242
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• 2017

Purpose: This study investigated the relationships among parenting stress, husband's support, and breastfeeding adaptation in mothers. Methods: A correlational survey design was utilized in this study. Data were collected from 181 breastfeeding mothers with infants under 12 months of age. Participants were recruited from the outpatient clinic, a child photo studio, or from the kid's cafe from July 22 to September 13, 2016. Instruments for collecting data included Childcare Stress Inventory (CSI), Husband's Support scale, and the Breastfeeding Adaptation scale. Data were analyzed using SPSS 21.0 by frequency, descriptive statistics, t-test, one-way ANOVA, Pearson's correlation coefficient and multiple regression. Results: Of the 181 subjects, 54.7% responded they only breastfed with 75.7% who received breastfeeding education. Seventy-two percent of mothers made a decision to breastfeed by themselves. The mean score was $2.39{\pm}0.53$ for parenting stress, $3.07{\pm}0.43$ for husband's support, and $3.85{\pm}0.49$ for breastfeeding adaptation. Factors influencing breastfeeding adaptation were identified as lower parenting stress (${\beta}=-.54$), greater husband's support (${\beta}=.31$), breastfeeding (${\beta}=.31$), and older age of baby (${\beta}=.14$), with 56.0% that explained variance. Conclusion: This study reports that parenting stress has negative effect on breastfeeding adaptation, while husband's support has positive effect. Results may be useful in developing new strategies for enhancing breastfeeding adaptation.

• Nutrition Research and Practice
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• v.11 no.1
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• pp.64-69
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• 2017

BACKGROUND/OBJECTIVES: This study was performed to measure fat-soluble vitamins and minerals in breast milk of Korean lactating mothers who exclusively breastfed their babies. SUBJECTS/METHODS: Breast milk samples were collected from 334 mothers. Concentrations of retinol and ${\alpha}$-tocopherol were analyzed by high performance liquid chromatography ultraviolet spectrometry while concentrations of minerals were measured by inductively coupled plasma optical emission spectrometry. RESULTS: Retinol and ${\alpha}$-tocopherol contents of breast milk were $39.58{\pm}19.64{\mu}g/dL$ and $0.23{\pm}0.13mg/dL$, respectively. Average sodium, potassium, calcium, phosphorus, and magnesium levels in breast milk were $11.11{\pm}5.16$, $38.56{\pm}9.01$, $27.87{\pm}6.10$, $13.56{\pm}3.30$, and $3.05{\pm}0.65mg/dL$, respectively. Contents of trace elements such as iron, zinc, copper, and manganese were $40.26{\pm}46.21$, $98.40{\pm}62.47$, $24.09{\pm}9.03$, and $0.90{\pm}1.63{\mu}g/dL$, respectively. Fat-soluble vitamin concentration was positively correlated with total fat in milk samples, but no significant differences were observed in levels of retinol, ${\alpha}$-tocopherol, or minerals based on whether or not lactating women were taking dietary supplements. CONCLUSIONS: Micronutrient contents of breast milk samples from Korean lactating women were comparable to those of other nations. Retinol and ${\alpha}$-tocopherol levels were correlated and also with total fat in breast milk.

• Journal of Nutrition and Health
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• v.23 no.3
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• pp.179-186
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• 1990

Nitrogen(N) concentrations of human milk in various fractions, such as total, protein, nonprotein, whey protein and casein were determined at 2-3 days, 1, 2, 4, 6 and 12 weeks of postpartum. significant decreases in total N, nonprotein N, protein N, whey protein N and casein N were found with time postpartum. Total nitrogen decreased from 401mg/dl at 2-3 days to 211mg/dl at 12 week. Whey protein nitrogen was found to contribute to the total nitrogen decrease with time. The percentage of nonprotein nitrogen was 13% in colostrum and 17-18% in mature milk. The proportions of whey protein and casein nitrogen were 55:45 at 2-3 days and 34:66 at 12 week postpartum. These determinations will provide the basic information on the variability of nitrogen components as lactation proceed.

• Nutrition Research and Practice
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• v.12 no.6
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• pp.512-520
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• 2018

BACKGROUND/OBJECTIVES: The 6-23 months for infants is the longest period in the "first 1,000 days" of life. This period is very important for child development, so complementary feeding (CF) practices should be optimized to maximize children's potential for growth and development. The aim of this study was to analyze the CF practices and nutritional status of children aged 6-23 months. SUBJECTS/METHODS: For this cross-sectional study, 392 children aged 6-23 months were selected using stratified random sampling. Socio-demographic data were collected through interviews. CF practices, collected by interviews and repeated 24-hour food recall method, were the timely introduction of CF, minimum meal frequency, dietary diversity and minimum acceptable diet, consumption food rich in proteins and vitamin A. Nutritional status was assessed using the indicators of underweight, wasting and stunting. To analyze the association between socio-demographic indicators and CF with nutritional status, the chi-square test with a confidence interval of 95% was used. RESULTS: Results showed that 39% were exclusively breastfed, only 61% received prolonged breastfeeding and 50% received timely introduction of CF. Minimum meal frequency was met by 74% of subjects, but dietary diversity and minimum acceptable diet were only realized in 50% and 40% of the children, respectively. The prevalence of underweight, wasting, and stunting were 26%, 23%, and 28%, respectively. Age of the child, birth order, birth weight, parents' education level, family size and incidence of fever and diarrhea during the previous two weeks were associated with underweight, while child's birth order, fathers' education level, mother's age, family size, completion of the age-appropriate vaccination and fish consumption frequency were associated with wasting. Age of the child, incidence of fever and acute respiratory infection, and fortified food consumption were associated with stunting. CONCLUSIONS: Suboptimal CF practices and high prevalence of underweight, wasting and stunting were found among children aged 6-23 months old in Aceh. These results highlight the need to improve CF and nutritional status.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.24 no.4
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• pp.392-402
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• 2021

Purpose: The present study assessed the role of an amino acid-based formula (AAF) in the growth of infants with cow's milk protein allergy (CMPA). Methods: Non-breastfed, term infants aged 0-6 months with symptoms suggestive of CMPA were recruited from 10 pediatric centers in China. After enrollment, infants were started on AAF for two weeks, followed by an open food challenge (OFC) with cow's milk-based formula (CMF). Infants with confirmed CMPA remained on AAF until 9 months of age, in conjunction with a cow's milk protein-free complementary diet. Body weight, length, and head circumference were measured at enrollment and 9 months of age. Measurements were converted to weight-for-age, length-for-age, and head circumference-for-age Z scores (WAZ, LAZ, HCAZ), based on the World Health Organization growth reference. Results: Of 254 infants (median age 16.1 weeks, 50.9% male), 218 (85.8%) were diagnosed with non-IgE-mediated CMPA, 33 (13.0%) tolerated CMF, and 3 (1.2%) did not complete the OFC. The mean WAZ decreased from 0.119 to -0.029 between birth and enrollment (p=0.067), with significant catch-up growth to 0.178 at 9 months of age (p=0.012) while being fed the AAF. There were no significant changes in LAZ (0.400 vs. 0.552; p=0.214) or HCAZ (-0.356 vs. -0.284; p=0.705) from the time of enrollment to age 9 months, suggesting normal linear and head growth velocity. Conclusion: The amino acid-based study formula, in conjunction with a cow's milk proteinfree complementary diet, supported normal growth till 9 months of age in a cohort of Chinese infants with challenge-confirmed non-IgE-mediated CMPA.

• Women's Health Nursing
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• v.27 no.4
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• pp.368-378
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• 2021

Purpose: The purpose of this study was to explore the association between breastfeeding and the prevalence of breast, thyroid, and cervical cancer among Korean adult women. Methods: The study was a secondary analysis of data from the Korea Genome and Epidemiology Study. The final samples were 113,944 Korean women among 173,205 urban-based cohort participants collected between 2004 and 2013 for adults aged forty and over. To determine the association between female cancers and breastfeeding experience, the number of childbirth, and total breastfeeding duration, logistic regression analysis was done. The demographic characteristics, health behavior, and female history were adjusted. Results: The prevalence of breast cancer was 1.37 times higher in the non-breastfeeding group than in the breastfeeding group. Compared to having breastfed for more than 36 months, the prevalence of thyroid cancer was 1.68 times higher at breastfeeding for 13 to 36 months, 1.67 times higher at breastfeeding for 6 to 12 months, and 2.06 times higher at breastfeeding less than 6 months. Also, the prevalence of cervical cancer was 1.54 times higher at breastfeeding for 13 to 36 months, compared to breastfeeding for more than 36 months. Conclusion: The study found that breastfeeding experience and a longer breastfeeding duration are associated with reduced risk of breast, thyroid, and cervical cancer in Korean women. It can be used as a basis for encouraging breastfeeding, and suggests further research on modifiable factors that reduce cancer risks.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.25 no.3
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• pp.263-275
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• 2022

Purpose: The present international survey among healthcare providers aimed to collect data on theoretical knowledge and clinical practices in the diagnosis and management of cow's milk protein allergy (CMPA) and lactose intolerance (LI) in infants. Methods: A global survey was conducted in several countries with diverse health care settings. The survey consisted of multiple-choice questions in 3 main domains: (1) understanding and clinical practices around CMPA and LI; (2) case scenarios; and (3) disease-specific knowledge and potential educational needs. Results: Responses were available from 1,663 participants. About 62% of respondents were general practitioners or general pediatricians, and the remainder were pediatric allergists/gastroenterologists (18%) or other health practitioners (20%). The survey identified knowledge gaps regarding the types of CMPA (IgE-mediated vs. non-IgE-mediated) and the clinical overlap with LI. The survey suggested diverse clinical practices regarding the use of hypoallergenic formulas, as well as misconceptions about the prebiotic benefits of lactose in extensively hydrolyzed formulas in non-breastfed infants with CMPA. Responses to the two case scenarios highlighted varying levels of awareness of the relevant clinical practice guidelines. While respondents generally felt confident in managing infants with CMPA and LI, about 80% expressed an interest for further training in this area. Conclusion: The current survey identified some knowledge gaps and regional differences in the management of infants with CMPA or LI. Local educational activities among general and pediatric healthcare providers may increase the awareness of clinical practice guidelines for the diagnosis and treatment of both conditions and help improve clinical outcomes.

• Nutrition Research and Practice
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• v.17 no.2
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• pp.307-315
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• 2023

BACKGROUND/OBJECTIVES: Previous studies have shown an association between breastfeeding and higher fruit and vegetable consumption and the level of dietary variety in children. However, few studies have reported this association on the feeding characteristics. Therefore, this study examined the association of the feeding characteristics with the consumption of fruit and vegetable and dietary variety in children. SUBJECTS/METHODS: This study recruited 802 participants from their parents with information on their feeding, and 24-h dietary recall. The associations of the feeding characteristics with fruit and vegetable consumption and dietary variety score (DVS) were analyzed using a multiple logistic regression model. RESULTS: Compared to the feeding type of exclusive breastfed children, exclusive formula-fed children had a significant association with a lower DVS (odds ratio [OR], 0.42, 95% confidence interval [CI], 0.23-0.77). Fruit and vegetable consumption was classified into 6 groups: non-salted vegetables (NSV), salted vegetables (SV), fruit (F), total vegetables (TV), non-salted vegetables + fruit (NSVF), and total vegetables + fruit (TVF). According to the mean level of fruit and vegetable consumption, compared to the duration of total breastfeeding for 6 month or less, a greater duration of breastfeeding for 12 mon had a significant association with a higher intake of NSVF and TVF (OR, 1.85, 95% CI, 1.20-2.85 and OR, 1.89, 95% CI, 1.22-2.92). On the other hand, the early introduction of formula feeding for 4 mon had a significant association with a lower intake of F and NSVF (OR, 0.59, 95% CI, 0.38-0.91 and OR, 0.63, 95% CI, 0.40-0.99). CONCLUSIONS: These results confirm that breastfeeding is associated with higher fruit and vegetable consumption and dietary variety, whereas formula feeding is associated with lower fruit and vegetable consumption and dietary variety. Therefore, the feeding characteristics in infants may affect fruit and vegetable consumption and dietary variety in children.