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      Seasonality of infant feeding practices in three Brazilian birth cohorts

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          Abstract

          Background We assessed the influence of season of birth on duration of breastfeeding and other feeding patterns in three population-based birth cohort studies in the city of Pelotas, Southern Brazil.

          Methods In 1982, 1993 and 2004, all hospital-born children in the city were enrolled in three cohort studies ( n = 5914, 5249 and 4287, respectively). Children and their mothers were periodically visited in the first 2 years of life, to collect information on the duration of breastfeeding and the ages at which different types of foods were introduced on a regular basis. Two independent variables were studied: month of birth and mean environmental temperature in the first month of life. Survival analyses and chi-squared tests were used to evaluate the associations. Temperature-based slope indices of inequality were also calculated.

          Results Duration of breastfeeding was lower among children born from April to June (months preceding winter) and spending their first month of life in colder temperatures. The influence of season of birth on breastfeeding patterns and the introduction of cow's milk differed according to maternal education, with the strongest effects among children belonging to less educated mothers. Early introduction of fruits (1982 and 1993 cohorts) and vegetables (1982 cohort) were also associated with lower environmental temperature in the first month of life, but not with trimester of birth.

          Conclusion Colder temperatures adversely affect duration of breastfeeding and feeding patterns in infancy, especially among the poorest. This finding should be considered in breastfeeding promotion programmes.

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          Most cited references34

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          Breastfeeding and the use of human milk.

          Considerable advances have occurred in recent years in the scientific knowledge of the benefits of breastfeeding, the mechanisms underlying these benefits, and in the clinical management of breastfeeding. This policy statement on breastfeeding replaces the 1997 policy statement of the American Academy of Pediatrics and reflects this newer knowledge and the supporting publications. The benefits of breastfeeding for the infant, the mother, and the community are summarized, and recommendations to guide the pediatrician and other health care professionals in assisting mothers in the initiation and maintenance of breastfeeding for healthy term infants and high-risk infants are presented. The policy statement delineates various ways in which pediatricians can promote, protect, and support breastfeeding not only in their individual practices but also in the hospital, medical school, community, and nation.
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            Measuring the magnitude of socio-economic inequalities in health: an overview of available measures illustrated with two examples from Europe.

            In this paper we review the available summary measures for the magnitude of socio-economic inequalities in health. Measures which have been used differ in a number of important respects, including (1) the measurement of "relative" or "absolute" differences; (2) the measurement of an "effect" of lower socio-economic status, or of the "total impact" of socio-economic inequalities in health upon the health status of the population; (3) simple versus sophisticated measurement techniques. Based on this analysis of summary measures which have previously been applied, eight different classes of summary measures can be distinguished. Because measures of "total impact" can be further subdivided on the basis of their underlying assumptions, we finally arrive at 12 types of summary measure. Each of these has its merits, and choice of a particular type of summary measure will depend partly on technical considerations, partly on one's perspective on socio-economic inequalities in health. In practice, it will often be useful to compare the results of several summary measures. These principles are illustrated with two examples: one on trends in the magnitude of inequalities in mortality by occupational class in Finland, and one on trends in the magnitude of inequalities in self-reported morbidity by level of education in the Netherlands.
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              Cohort profile: the 1993 Pelotas (Brazil) birth cohort study.

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                Author and article information

                Journal
                Int J Epidemiol
                Int J Epidemiol
                ije
                intjepid
                International Journal of Epidemiology
                Oxford University Press
                0300-5771
                1464-3685
                June 2012
                21 February 2012
                21 February 2012
                : 41
                : 3
                : 743-752
                Affiliations
                1Post-graduate Program in Nutrition, Federal University of Santa Catarina, Florianópolis, SC, Brazil, 2Post-graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, RS, Brazil and 3Department of Food Science and Nutrition, California Polytechnic State University, San Luis Obispo, CA, USA
                Author notes
                *Corresponding author. Departmento de Nutrição, Campus Universitário, Universidade Federal de Santa Catarina, Bairro Trindade, CEP 88040-900, Florianópolis, SC, Brazil. E-mail: david.epidemio@ 123456gmail.com
                Article
                dys002
                10.1093/ije/dys002
                3396312
                22354916
                55cdcfa2-89ed-4a5b-a178-c9f7efab702a
                Published by Oxford University Press on behalf of the International Epidemiological Association © The Author 2012; all rights reserved.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/3.0), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 5 January 2012
                Page count
                Pages: 10
                Categories
                Life Course Epidemiology

                Public health
                cohort studies,breastfeeding,temperature,supplementary feeding,climate
                Public health
                cohort studies, breastfeeding, temperature, supplementary feeding, climate

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