The retrospective cohort study by Grummer-Strawn and Mei (2004) sought to answer the research question: Is increasing duration of breastfeeding associated with a lower risk of overweight among a low-income population of 4 year olds in the United States (US)?35 The researchers aimed to increase the internal validity of their study by including a large sample, controlling for various child and maternal confounders (i.e., covariates), and stratifying analyses by race/ethnicity; however, as previously discussed, study design and execution issues (e.g., recall, social desirability and selection biases, and confounding) threatened its validity.44
Study Design
An observational, prospective, pre-/post-birth cohort study, with a nested sibling cohort,
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Importantly, the prospective pre-/post-birth cohort design facilitates strong time order assessment by assessing obesity incidence well into childhood, as participants are exposure-free at birth and accrue person-time until obesity diagnosis, loss to follow-up, or study conclusion at age 7, thus bolstering causal inference.44 The selection of FQHCs as the research setting, as well as the study’s sampling methodology, improves assessment of the breastfeeding-obesity association among low-income, racial/ethnic minority populations that are disproportionately impacted by childhood obesity.7–9 Prolonged exposure measurement (≥24 months) offers clearer assessment of how breastfeeding duration and related indicators (e.g., exclusivity and difficulty) impact child obesity incidence over …show more content…
BMI is an imperfect measure of obesity (e.g., does not measure adiposity).57 Yet, because BMI-for-age at ≥95th percentile, based on CDC growth charts, has been determined to be a moderately sensitive and specific measure of excess adiposity among children, and other measures (e.g., neck circumference) lack reliability and validity, this was determined to be the most appropriate way to measure the outcome.58,59 As with all observational studies, prospective cohort studies are subject to bias, confounding, and random error due to lack of randomization, which may impact results.44 For example, although efforts will be made to improve self-reporting of breastfeeding behaviors, recall and social desirability bias may arise. However, given that a randomized controlled trial—the gold standard— will not be possible to conduct, as randomizing mothers to breastfeeding is unethical and unfeasible, this design was deemed to be most
Darien is a patient who possibly displays comorbidity. His symptoms lead me to believe that he could possibly be diagnosed with obsessive-compulsive disorder and generalized anxiety disorder. Darien’s symptoms that point to OCD are that he has rituals he must complete and if he does not he becomes anxious and is unable to continue with his day. He is however aware that these rituals are not actually helping him but he cannot stop doing them. He also reports feeling anxious most of the day, especially if he cannot perform his rituals, and that he is becoming increasingly more anxious. He is also unable to keep himself from worrying and feeling anxious.
This article from CDC talk about the basics about childhood obesity. It provides information on how childhood overweight and obesity is measured by calculating an individual’s body mass index (BMI). It also states some consequences that are related to childhood obesity, both consequences that can happen now and later...
Breastfeeding rates are continually increasing. The nutritional benefit of breast over formula is a long established fact. “According to the latest numbers from the Centers for Disease Control and Prevention, breastfeeding rates improved nationwide in 2000-2008, and some of the greatest improvement was among black women. However, only about 59 percent of black mothers breastfed in 2008, compared to 80 percent of Hispanic mothers and about 75 percent of white mothers. For 2008 rates of breastfeeding at a baby’s first birthday, the number was about 23 percent overall but only 12.5 percent for black mothers. That low rate still marks a near doubling of rates among black mothers compared to the year 2000” (Currie, 2013).It is the recommended method of feeding an infant for at least the first six months of life. Breastfeeding has benefits to both mothers and their babies. The baby receives immunity to protect it from disease. Financially, breastfeeding can significantly reduce the burden of having a new child. Many mothers initiate breastfeeding in the hospital; however, the number of women who breastfeed until six months is very low (Guyer, Millward, & Berger, 2012). Breastfeeding is highly favored over bottle feeding. Yet, mothers still do not choose to continually breastfeed their infants. Do mothers who breastfeed during hospitalization have limitations or no desire to continue versus mothers who breastfeed for the recommended six months or longer at home?
According to the Center for Disease Control (CDC) about “17% (or 12.5 million) of children and adolescents aged 2-19 years are obese” (Moreno et al., 2013 P.157). “Surveys administered in 1976-1980 and 2007-2008 show that the prevalence of obesity has changed from 6.5% to 19.6% among children 6-11 years old age and from 5.0% to 18.1% for those aged 12-19 years (Moreno et al., 2013 P.157).
Institute of Medicine. (n.d.). Retrieved Jan 10, 2011, from Childhood Obesity Prevention Actions for Local Government: www.iom.edu/Activities/Childhood/LocalObesPrevention.asp
Further evidence is becoming available of more detailed analyses of the incidence of obesity by age, sex and geographical region. Using graph (i) below, produced for the National Child Measurement Programme from the NHS Information Centre (2009), we can see that the percentages of children falling into the “underweight”, “overweight” and “obese” categories remain generally stable over the three years reviewed, except that there was an increase of just over 1% in the “obese” category between 2006/07 and 2008/09. It is, however, disturb...
In comparism with the general public, there is high occurrence of childhood obesity among ethnic minorities especially South Asians and African Caribbean’s (Office of National Statistics, 2004). They are more likely to be at the lower socio
Rear Admiral Galson, S. K. (July 2008). Mothers and Children Benefit from Breastfeeding. American Dietic Association Vol 108 Issue 7 , p 1106.
...r their child’s risk of being overweight or obese, which is a risk factor for type 2 diabetes. (NDEP, 2013) Breastfeeding also helps you lose the weight gained during pregnancy.
Breastfeeding provides a wide array of health benefits for both baby and mother, while simultaneously enhancing the bond between mom and her baby. Mothers who breastfeed have a lower risk of ovarian and pre-menopausal breast cancer. Their babies see a boost in cognitive development, as well as lowering their chances of being obese as adults, unlike formula fed babies. Consequently, a lower risk of obesity correlates to a lower incident of a wide array of comorbidities such as
May, Ashleigh L., et al. Vital Signs: Obesity Among Low-Income, Preschool-Aged Children – United States, 2008-2011. MMWR: Morbidity & Mortality Weekly Report 62.31 (20130): 629-634. Consumer Health Complete – EBSCOhost. Web. 19 Nov. 2013.
Bronte-Tinkew, J., Zaslow, M., Capps, R., & Horowitz, A. (2007). Food insecurity and overweight among infants and toddlers: New insights into a troubling linkage. Washington, DC: Child Trends.
One of the study designs used in epidemiology is the cohort study (Heavey, 2015). The epidemiology studies are used to examine the distribution of disease (Heavey, 2015). The cohort epidemiology study examines the distribution of disease by following a group of prospects over a period of time and evaluating those that develop the outcome of interest (Heavey, 2015). One of the most important task that must be completed prior to the cohort study is the removal of prevalence cases (Heavey, 2015). This simply means that those who already have the disease of interest must be eliminate (Heavey, 2015).
The researchers followed earlier study leads by equaling initiation of breastfeeding and formula fed exclusively to equal 1. Along with analyzing other breastfeeding durations including months spent breastfeeding before formula and age child received first formula fed. Also concluded from the earlier studies what maternal and household characteristics encourage the action of breastfeeding and differences in geographic campaign on breastfeeding promotion. The researchers “Control variables included child sex, race, and ethnicity; mother’s age, education, and marital status; and household participation in the Special Supplemental Nutrition Program for Women, Infants, and Children (ever) and number of children” (Gurley-Calvez, Bullinder, & Kapinos,
Hufmann, G. F., Kanikireddy, & Patel (2010). Parenthood-A contributing factor to childhood obesity. International Journal of Environment Research and Public Health, (7)7:2800-2810