• 한국산학기술학회논문지
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• 제15권3호
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• pp.1671-1680
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• 2014

본 연구는 농촌지역의 모유수유 실태를 파악하고 이에 영향을 미치는 관련 요인을 살펴보고자 하였다. 2012년 3월 20일부터 4월 19일까지 울산광역시 울주군의 보건소 및 보건지소와 어린이집을 다니는 60개월 미만의 영유아를 둔 어머니 139명을 대상으로 실시하였다. 자료분석은 SPSS Win 18.0 프로그램을 이용하였고 영역별 분석은 평균과 표준편차, 다중회귀분석으로 통계적 진술하였다. 다중 로지스틱 회귀분석 결과 모유수유에 영향을 미치는 관련 요인으로는 어머니의 직장유무, 산전 모유수유 교육 여부, 생후 1개월에 완전모유수유 유무가 영향을 미치는 것으로 나타났다. 지속적인 완전모유수유율을 높이기 위해서는 분만 전 병의원이나 보건소 등을 통한 교육의 실시, 직장 여성에게는 출산휴가나 육아휴직 사용 등으로 인한 불이익이 없는 지역사회 환경이 필요할 것으로 사료된다.

• Journal of Preventive Medicine and Public Health
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• 제56권5호
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• pp.422-430
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• 2023

Objectives: Prolactin is vital for breastfeeding and milk production, and its secretion is influenced by factors related to the mother, infant, and environment. To date, no study has concurrently investigated the correlation of these factors with serum prolactin levels during lactation. Therefore, the objective of this study was to investigate the correlations among maternal and infant factors, lead exposure, and serum prolactin levels during lactation. Methods: A cross-sectional approach was employed in Surabaya, Indonesia, among 110 exclusively lactating mothers. The mothers' daily diets were determined using multiple 24-hour recalls, while blood lead levels were measured with inductively coupled plasma mass spectrometry. Serum prolactin levels were assessed using the electrochemiluminescence immunoassay. For bivariate analysis, we employed the Spearman correlation, Mann-Whitney, and Kruskal-Wallis tests, while for multivariate analysis, we utilized multiple linear regression. Results: The average serum prolactin level of the lactating mothers was 129.19±88.96 ng/mL. Positive correlations were found between serum prolactin levels and breastfeeding frequency (p<0.001), protein intake (p<0.001), and calcium intake (p=0.011) but had negative correlation with blood lead levels (p<0.001) and vitamin B6 intake (p=0.003). Additionally, prolactin levels were not significantly associated with maternal age; parity; intake of calories, vitamin D, vitamin E, zinc, folic acid, magnesium, or iron; infant age; or infant sex. Conclusions: Breastfeeding frequency had a stronger positive relationship with serum prolactin levels than protein and calcium intake. However, lead exposure was associated with reduced serum prolactin levels during lactation. Consequently, specific interventions from policymakers are necessary to manage breastfeeding in mothers exposed to lead.

• Asian Pacific Journal of Cancer Prevention
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• 제16권7호
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• pp.2959-2965
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• 2015

The incidence and mortality rates of breast cancer in Northeast Brazil are increasing and little is known about prevailing reproductive factors contributing to this increase. A case-control study was conducted in a public hospital of Campina Grande, state of $Para{\acute{i}}ba$, including 81 women with diagnosed invasive breast cancer and 162 age matched (${\pm}5years$) controls. Binominal logistic regression analysis was applied to estimate odds ratio (OR) and confidence intervals (CI) of risk factors. In this model, age at menarche ${\leq}12$ (OR=2.120; CI: 1.043-4.308; p=0.038), single parity (OR=3.748; CI: 1.459-9.627; p=0.06) and reproductive period >10 years (OR=3.042; CI: 1.421-6.512; p=0.04) were identified as independent variables that significantly increased breast cancer risk of parous women. Compared to parous women who never practised breastfeeding, total breastfeeding time > 24 months decreased the risk of breast cancer (OR=0.258; CI: 0.084-0.787; p=0.017). The results indicated that modifiable reproductive factors contribute to breast cancer risk in women included in the present study. Women's knowledge about factors such as the protective effect of breastfeeding could reduce the risk of breast cancer.

• Journal of Preventive Medicine and Public Health
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• 제49권6호
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• pp.349-366
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• 2016

Objectives: We conducted a systematic review and meta-analysis to summarize current evidence regarding the association of parity and duration of breastfeeding with the risk of epithelial ovarian cancer (EOC). Methods: A systematic search of relevant studies published by December 31, 2015 was performed in PubMed and EMBASE. A random-effect model was used to obtain the summary relative risks (RRs) and 95% confidence intervals (CIs). Results: Thirty-two studies had parity categories of 1, 2, and ${\geq}3$. The summary RRs for EOC were 0.72 (95% CI, 0.65 to 0.79), 0.57 (95% CI, 0.49 to 0.65), and 0.46 (95% CI, 0.41 to 0.52), respectively. Small to moderate heterogeneity was observed for one birth (p<0.01; Q = 59.46; $I^2=47.9%$). Fifteen studies had breastfeeding categories of <6 months, 6-12 months, and >13 months. The summary RRs were 0.79 (95% CI, 0.72 to 0.87), 0.72 (95% CI, 0.64 to 0.81), and 0.67 (95% CI, 0.56 to 0.79), respectively. Only small heterogeneity was observed for <6 months of breastfeeding (p = 0.17; Q = 18.79, $I^2=25.5%$). Compared to nulliparous women with no history of breastfeeding, the joint effects of two births and <6 months of breastfeeding resulted in a 0.5-fold reduced risk for EOC. Conclusions: The first birth and breastfeeding for <6 months were associated with significant reductions in EOC risk.

• 대한지역사회영양학회지
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• 제11권3호
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• pp.327-337
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• 2006

The major purpose of this study was to develop the nutrition education contents and material through the basic data from the service provider and the consumer. And also, to find out the differences of attitude and needs between the service provider (SP breastfeeding specialist), present consumer (PC, pregnant or lactating women) and future consumer (FC, college women). There were types of questionnaires, which consisted of needs and attitudes toward child and maternal nutrition, as well as the personal characteristics of the study subjects. The subjects consisted of 113 breastfeeding specialists who served at medical related institutions, 197 pregnant or lactating women and 309 college women. The self-administered questionnaires from subjects were collected from October to November 2005 in Seoul and Kyunggi Province. The data was analysed by SPSS Win 12.0, ANOVA and Kruskal-Wallis test. The results of this study were as following: 1) The most Important determining factors on breastfeeding was 'medical specialist's support' (3.51) and the next one was 'knowledge of maternity care practice' (3.39). And the importance score of determinating factors on breastfeeding was significantly different between each group (p < 0.001). The groups of consumer (3.50 at PC and 3.59 at FC) considered the service provider (3.32) more important. The service providers considered a more effective determining factor to be 'husband and family support' and 'peer support' than the others (p <0.001). 2) To compare the effective factors of breastfeeding practices between the three groups, the service providers were more significantly considered than the otters such as 'attendance of intervention program' (p < 0.001). But the PC group considered the most effective factors wis 'mother's job after delivery'. 3) The self-evaluated score of the breastfeeding knowledge was the most high in SP; the score was significantly different between groups. The knowledge score of nutritional aspects in human milk was most highly evaluated. But maternity care practice and public acceptance marked the lower evaluation score than other issues. 4) The desirable types of educational material was mass media, and the next was printed matter such as booklets. Two kinds if consumers preferred DVD or VCR tapes than and the service provider group (p < 0.001). 5) The priority contents of nutrition service PC group wanted the information about infant care more than maternal care (p < 0.05), but FC group's priority was significantly different compared with PC group (p < 0.001). The priority of SP group pointed out the information of practical child care methods. The results showed the needs of nutrition service, education channels, and perception toward effective factors on consumer behavior changes were significantly different between each group. Thus the result of this study may suggest that consumer oriented nutrition service programs must be developed.

• 대한한의학회지
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• 제40권2호
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• pp.106-118
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• 2019

Objectives: The aim of this study is to survey on the effect of Korean medicine health promotion program for maternal health. Methods: We conducted Korean medicine health promotion program for maternal health to pregnant women who agreed to participate in this program among 10 public health center. Before and after program, we surveyed the Knowledge Score of Maternal Health Care, Practice of Health Behavior, (Traditional) Child Care Recognition, Depression, Child Caring Confidence and analyzed DID(Difference In Difference). Results: The Knowledge Score of Maternal Health Care of intervention group was improved about 1 point. The improvement of (Traditional) Child Care Recognition was significant. Depression score of intervention group was improved high significantly. The Child Caring Confidence of intervention group was improved about 1.3 point. Conclusion: As a result of analyzing the effect of Korean medicine health promotion program for maternal health, it is confirmed that this program can have an impact on improving Knowledge Score of Maternal Health Care, (Traditional) Child Care Recognition, Depression, Child Caring Confidence. It will be necessary to continue and develop this program widely.

• Journal of Preventive Medicine and Public Health
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• 제50권6호
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• pp.401-410
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• 2017

Objectives: The purpose of this study was to examine the associations of childbirth, breastfeeding, and their interaction with breast cancer (BC) risk reduction, and to evaluate the heterogeneity in the BC risk reduction effects of these factors by menopause, hormone receptor (HR) status, and pathological subtype. Methods: BC patients aged 40+ from the Korean Breast Cancer Registry in 2004-2012 and controls from the Health Examinee cohort participants were included in this study after 1:1 matching (12 889 pairs) by age and enrollment year. BC risk according to childbirth, breast-feeding, and their interaction was calculated in logistic regression models using odds ratios (ORs) and 95% confidence intervals (CIs). Results: BC risk decreased with childbirth (3+ childbirths relative to 1 childbirth: OR, 0.66; 95% CI, 0.56 to 0.78 and OR, 0.80; 95% CI, 0.68 to 0.95 in postmenopausal and premenopausal women, respectively); and the degree of risk reduction by the number of children was heterogeneous according to menopausal status (p-heterogeneity=0.04), HR status (p-heterogeneity<0.001), and pathological subtype (p-heterogeneity<0.001); whereas breastfeeding for 1-12 months showed a heterogeneous association with BC risk according to menopausal status, with risk reduction only in premenopausal women (p-heterogeneity<0.05). The combination of 2 more childbirths and breastfeeding for ${\geq}13$ months had a much stronger BC risk reduction of 49% (OR, 0.51; 95% CI, 0.45 to 0.58). Conclusions: This study suggests that the combination of longer breastfeeding and more childbirths reduces BC risk more strongly, and that women who experience both 2 or more childbirths and breastfeed for ${\geq}13$ months can reduce their BC risk by about 50%.

• Pediatric Infection and Vaccine
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• 제16권2호
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• pp.191-198
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• 2009

목 적: 만성 B형 간염 산모로부터 분만된 신생아에게 주산기 예방조치를 실시하면 모유수유는 권장되어져야한다. 그러나 실지로 국내에서는 높은 비율에서 산모들은 모유수유를 꺼리고 있다. 설문조사를 통하여 이 같은 현상이 초래되는 요인을 찾아보았다. 방 법: 질병관리본부가 주관하는 'B형간염수직감염예방사업'에 참여하여 등록된 만성 B형 간염 산모 중 보건소에서 혈액 채취를 위해 보건소를 방문하고 동의서에 서명을 얻은 경우를 대상으로 하였다. 검사 결과를 고지할 때 이들의 모유수유에 대한 인식을 조사하기 위하여 반송봉투와 함께 설문지를 발송하였다. 결 과: 설문지를 발송한 839명 중 주소 이전 등의 이유로 반송된 114명을 제외한 725명이 설문지를 모두 받았다고 가정할 때 응답율은 17% (125명)이었다. 응답자의 수유방법은 모유 65명(52%), 분유 60명(48%)이었다. 모유수유를 한 경우 가장 영향을 미쳤던 요인은 본인 및 가족의 결정 75%, 산부인과 의사 17%이었고, 분유수유를 한 경우는 산부인과 의사 57%, 본인의 결정 28%이었다. 모유수유와 주산기 예방조치 실패간의 관련성에 대한 인식은 '관련이 있다' 45%, '관련이 없다' 50%이었고, 관련이 있다고 했을 때의 관련 정도는 '어느 정도 관련이 있다'가 55%이었다. 모유수유를 한 경우 추후에 모유수유를 하겠다는 답변은 91%이었고, 분유수유를 하였지만 '모유수유가 주산기 예방조치 실패와 직접적인 관련이 없다'는 사실이 소개된다면 추후에는 모유수유를 선택하겠다는 경우가 78%이었다. 결 론: 모유수유가 B형 간염 주산기 예방조치의 실패와 직접적인 관련이 없음에도 불구하고 많은 숫자에서 모유수유를 하지 않고 있는데, 이러한 결정을 하게 된 경우의 대부분이 의료인에 의해서였다. 교육을 통한 의료인들의 개념전환과 국민홍보가 이루어져야할 것이다.

• 대한지역사회영양학회지
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• 제6권3호
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• pp.354-360
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• 2001

This study was carried out to investigate the present status of nutrition services for infants in public health centers and the need for nutrition services of health workers and infants mothers. The study subjects were 146 health workers and 197 infants mothers. The results were as follows : At present, the only major nutrition services for infants were vaccination and dental care. Proper nutrition management services were available to infants. Nutrition knowledge scores were 16.8 for health workers and 15.3 for mothers out of 20 possible points. Health workers strongly demanded a well-organized nutrition education program, government support, audio-visual materials and the employment of a community nutritionist. The public health workers, in particular, demanded the development of education programs for breastfeeding and weaning. The infants mothers demanded services of nutrition information and teaching of cooking and menu planning. Based on this, the results suggest that the employment of a community nutritionist and the development of practical nutrition service programs for infants are needed very urgently for public health centers.

• Nutrition Research and Practice
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• 제3권3호
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• pp.171-179
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• 2009

Onto the world-fastest ageing of society, the world-lowest fertility rate prompted a development of various policies and programs for a betterment of the population in Korea. Since the vulnerability of young children of low socio-economic class to malnutrition was clearly shown at the in-depth analysis of the 2001 Korea National Health and Nutrition Examination Survey data, an effort to devise supplemental nutrition care program for pregnant/breastfeeding women, infants and preschool children was initiated. The program was designed to offer nutrition education tailored to fit the needs of the participants and special supplementary foods, using USDA WIC program as a benchmark. Based on the dietary intake of those age groups, target nutrients were selected and their major food sources were searched through nutrient content of foods and dietary pattern analysis. As a result, we developed 6 kinds of food packages using combinations of 11 different food items. The amount of each item in a food package was determined to supplement the intake deficit in target nutrients. Nutrition education in $NutriPlus^+$ aims to improve the nutrition knowledge, attitude, and dietary behaviors of the participants, and is provided through group lessons, individual counseling sessions and home visits. Breastfeeding is promoted with top priority in education for the health of both mother and baby. The eligibility guidelines were set for residency, household income, age, pregnancy/breastfeeding and nutritional risk such as anemia, stunting, underweight, and/or inadequate nutrient intake. Income eligibility was defined as household income less than 200 percent of the Korean poverty guidelines. A pilot study to examine the feasibility of program implementation was run in 3 public health centers in 2005 and expanded to 15 and 20 in the following 2 years. The result of 3-year pilot study will be reported separately along with the ultimate nationwide implementation of the $NutriPlus^+$ in 2008.