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Journal Articles

Uncovering Hidden Patterns: Use Of Infant Feeding Profiles In The First 6 Months Postpartum To Inform The Effectiveness Of Breastfeeding Promotion Programs

Frontiers in Public Health, 2026

Introduction: Longitudinal trends in breastfeeding (BF) are often overlooked in favor of binary or time-to-cessation measures. Characterizing these trends can inform promotion of sustained BF practices. We identified distinct BF profiles among participants of a maternal and child health program.

Methods: The Healthy Future program consisted of community health workers delivering a BF curriculum to mothers through monthly home visits. The program was evaluated in rural Sichuan, China with a cluster-randomized controlled trial (assigned to program versus not). We clustered 6-month postpartum trends (n = 949) of maternal-reported infant feeding using dynamic time warping. For each month, participants were categorized as either exclusive breastfeeding (EBF), mixed feeding (MF, feeding breastmilk plus other foods or liquids), or not breastfeeding (NBF). After identifying clusters, we regressed BF profiles on intervention assignment using adjusted multinomial logistic regression.

Results: Cluster analysis revealed seven profiles: always EBF, always MF, never breastfed, EBF until the 5th month, MF until the 5th month, mostly EBF, and NBF from the 3rd month. The intervention was associated with improved odds of always EBF (ROR = 2.61, 95% CI 1.25, 5.42), MF until the 5th month (ROR = 2.52, 95% CI 1.18, 5.39), and NBF from the 3rd month (ROR = 2.82, 95% CI 1.16, 6.87) compared to being never breastfed. Mothers in the never breastfed cluster had the lowest age, education, BF knowledge and attitudes, and decision-making power.

Discussion: Cluster analyses found the intervention significantly improved EBF, particularly in mothers characterized by higher baseline educational attainment and BF knowledge. Targeted efforts are needed to help mothers initiate EBF from birth and continue EBF through month 6.

Rural China and the Gender Gap in Early Social-emotional Development

Children and Youth Services Review, 2024

Journal Articles

In-Hospital Formula Feeding Hindered Exclusive Breastfeeding: Breastfeeding Self-Efficacy as a Mediating Factor

Nutrients, 2023

Journal Articles

How Does the Family Environment Affect Toddlerhood Language and Cognitive Development? Evidence from Peri-urban China

Applied Developmental Science, 2023

Journal Articles

Effect of the mHealth-Supported Healthy Future Programme Delivered by Community Health Workers on Maternal and Child Health in Rural China: Study Protocol for a Cluster Randomised Controlled Trial

BMJ Open, 2023

Introduction Millions of young rural children in China still suffer from poor health and malnutrition, partly due to a lack of knowledge about optimal perinatal and child care among rural mothers and caregivers. Meanwhile, there is an urgent need to improve maternal mental health in rural communities. Comprehensive home visiting programmes delivered by community health workers (CHWs) can bridge the caregiver knowledge gap and improve child health and maternal well-being in low-resource settings, but the effectiveness of this approach is unknown in rural China. Additionally, grandmothers play important roles in child care and family decision-making in rural China, suggesting the importance of engaging multiple caregivers in interventions. The Healthy Future programme seeks to improve child health and maternal well-being by developing a staged-based curriculum that CHWs deliver to mothers and caregivers of young children through home visits with the assistance of a tablet-based mHealth system. This protocol describes the design and evaluation plan for this programme.

Methods and analysis We designed a cluster-randomised controlled trial among 119 rural townships in four nationally designated poverty counties in Southwestern China. We will compare the outcomes between three arms: one standard arm with only primary caregivers participating in the intervention, one encouragement arm engaging primary and secondary caregivers and one control arm with no intervention. Families with pregnant women or infants under 6 months of age are invited to enrol in the 12-month study. Primary outcomes include children’s haemoglobin levels, exclusive breastfeeding rates and dietary diversity in complementary feeding. Secondary outcomes include a combination of health, behavioural and intermediate outcomes.

Journal Articles

Stimulation and Early Child Development in China: Caregiving at Arm's Length

Journal of Developmental and Behavioral Pediatrics, 2019

Publications

Publications

Uncovering Hidden Patterns: Use Of Infant Feeding Profiles In The First 6 Months Postpartum To Inform The Effectiveness Of Breastfeeding Promotion Programs

Rural China and the Gender Gap in Early Social-emotional Development

In-Hospital Formula Feeding Hindered Exclusive Breastfeeding: Breastfeeding Self-Efficacy as a Mediating Factor

How Does the Family Environment Affect Toddlerhood Language and Cognitive Development? Evidence from Peri-urban China

Effect of the mHealth-Supported Healthy Future Programme Delivered by Community Health Workers on Maternal and Child Health in Rural China: Study Protocol for a Cluster Randomised Controlled Trial

Stimulation and Early Child Development in China: Caregiving at Arm's Length

Uncovering Hidden Patterns: Use Of Infant Feeding Profiles In The First 6 Months Postpartum To Inform The Effectiveness Of Breastfeeding Promotion Programs