Displaying all 6 publications

  1. Basma Johari, Nor Azwani Mohd Shukri
    Exclusive breastfeeding (EBF) for up to six months is internationally recommended due to its benefits for both maternal and infant health. However, the rate of EBF in Malaysia is still below the desirable levels. This study examined the prevalence of EBF and assessed the knowledge, attitude, and practice (KAP), and determinants of breastfeeding among Malay mothers in Ampang, Selangor. Ninety-two Malay subjects who breastfed healthy children aged six to 36 months, were included in this study. Data were collected by dual-language, self-administered questionnaire (which included Iowa Infant Feeding Attitude Scale, IIFAS), to determine KAP of mothers towards breastfeeding. Socio-demographic, psychosocial, and environmental factors related with EBF were also assessed. Linear logistic regression model was used to identify factors that may determine breastfeeding for six months (exclusively) and beyond. A total of 28% of the subjects practised EBF up to six months, 39% less than six months, and 33% continued BF beyond six months. The mean IIFAS total score was 66.1 ± 8.11, which ranged between Neutral and Positive towards Breastfeeding Practice attitudes. Higher IIFAS score is related to intended and actual exclusive
    breastfeeding. Several variables were significantly related to breastfeeding for six months (exclusively) and beyond. This included maternal age of 30 years or more (OR:3.26, 95% CI:1.27–8.38); higher socioeconomic status (OR:8.50, 95% CI:1.76–41.06); higher educational level (OR:5.21, 95% CI:1.66–16.34); multi-parity (OR:3.15, 95% CI:1.17–8.47); nonworking status (OR:3.81, 95% CI:1.02–14.3); support from spouse (OR:2.39, 95% CI:1.01–5.65); availability of private rooms for breastfeeding at workplace (OR:4.30, 95% CI:1.77–10.63); and child birth place (OR:2.54, 95% CI:1.08–5.98). The right maternal knowledge and attitude play crucial roles in the success of breastfeeding. Hence, more health promotion is needed. Supports from spouse,
    workplace, and hospital staff after delivery, are also essential to improve EBF statistics in Malaysia.
  2. Nor Faezah Baba, Nur Faten Abu Samah, Nor Azwani Mohd Shukri
    Pregnancy is a crucial period for mothers to ensure proper weight gain and adequate nutrients intakes. This is important for healthy fetal growth. There are increasing numbers of maternal milk supplements which claimed to provide the essential nutrients that are needed during pregnancy such as iron, folic acid, and docohexanoic acid. The current study was conducted to assess the practice of maternal milk supplements (MMS) intake among pregnant women in Kuantan, Pahang, whether or not its consumption plays a role in meeting the requirements for total energy and
    nutrients intakes. Questionnaires regarding intake of MMS were distributed to 150 subjects to observe the practice of its consumption. A total of 54 subjects (from 2nd and 3rd trimesters) were interviewed to obtain their diet history using multiple pass 24-hours dietary recall method. Their total energy and nutrients intakes were compared to the Recommended Nutrients Intake for Malaysia (RNI, 2005). It was found that almost three quarter (70%) of the subjects consumed MMS. Women who consumed MMS during pregnancy were found to be significantly younger, of lower parity and lower pre-pregnancy body mass index. It was also shown that the women’s dietary intakes without MMS supplementation were insufficient to meet the RNI for total energy and
    some selected nutrients. The results of this study indicate that MMS could play a role in increasing the dietary intakes of total energy, protein, and calcium, of pregnant women who are not consuming these nutrients sufficiently as recommended.
  3. Siti Munirah Abdul Basir, Muhammad Safwan Abdul Rahman, Wan Azdie Mohd Abu Bakar, Nor Azwani Mohd Shukri
    Traditional postpartum practices generally involve food proscriptions and prescriptions. Certain foods are prohibited due to their properties such as “windy”, “cold” and “hot”. As lactating mother needs higher energy and protein intake, this practice may impact their ability to meet their nutritional requirements. Consequently, their health may not be fully restored, wound healing would be slowed, and lactation success may be interfered. This study was conducted in Kuantan, Pahang, to investigate Malay mothers’ perception on confinement dietary practices during postpartum period. A total of 80 respondents aged between 23-43 years old were interviewed using a questionnaire which consisted of an extensive list of food items. It was found that 100% of respondents mentioned that they do observe the traditional postpartum practices after childbirth with most of them (63.0%) chose to confine for up to 44 days. Flavored rice, roti canai and various types of noodle were generally avoided during postpartum period due to their ‘oily/fatty’ property. Tubers, and most fruits and vegetables were also avoided due to their ‘cold’ property. Moreover, the famous ‘reason’ for exclusion of fish was ‘bisa’ and ‘causing itchiness’ for seafood. Milk and dairy products were included in majority of respondents’ diet. Out of 80, 43 (53.8%) respondents avoided soy sauce because it was believed to give negative effect on wound healing. Other than
    that, iced drink, tea and sugarcane drink were avoided due to their ‘cold’ and ‘sharp/sour’ properties. In addition, statistical tests of all food items show that there is no difference in terms of level of acceptance for each food between women delivered via normal delivery or caesarean section. It is concluded that postpartum food taboo beliefs are still prevalent among Malay women. Extensive food prohibition and restriction causes limited food choices which may affect mothers’ nutritional intake. Thus, a more balanced diet should be recommended for Malay mothers during postpartum period to ensure adequate nutrient intake, as much as culturally acceptable.
  4. Siti Munirah Abdul Basir, Radiah Abdul Ghani, Muhammad Ibrahim, Muhammad Muzaffar Ali Khan Khattak, Muhammad Nor Omar, Nor Azwani Mohd Shukri
    Introduction: Nutritional requirements increase during lactation. However, maternal dietary intakes of Malaysian
    mothers are subjected to restrictions commonly included in traditional postpartum practices. This study aimed to
    assess the maternal dietary intake status during the recommended six month exclusive breastfeeding (part of which
    included the traditional confinement) period. Methods: Thirty-two Malay mothers aged 18-35 years, who had delivered full-term (at ≥37 weeks) singleton babies and were exclusively breastfeeding, were included in the study.
    Maternal dietary intake was assessed using multiple-pass diet recall on Days 10, 30, 60, 90, 120, 150, and 180,
    postpartum. The average total energy and macronutrient intakes were compared against recommended values. Results: The findings of this study demonstrated that maternal intakes of total energy ranged from 1,500-2,000kcal/day,
    carbohydrate 189-272g/day, protein 58-72g/day, and total fat 32-70g/day. Total calorie intake was the lowest during
    confinement period (Days 10 and 30) compared to the rest of the exclusive breastfeeding period. This is similar with
    total fat consumption. On the other hand, protein intake was the highest during confinement period whereas carbohydrate intake was consistent throughout the six-month period. Despite the increased requirements, intakes of total
    calories, protein, total fat, dietary fibre, and water, did not meet the recommended values throughout the exclusive
    breastfeeding period. Conclusion: Mothers’ inability to fulfil their nutritional requirements during exclusive breastfeeding period may be associated with traditional postpartum dietary practices. Dietary advice with consideration
    for cultural food taboos practiced by local mothers during confinement may help to improve maternal nutritional
    intakes during this crucial time.
  5. Siti Munirah Abdul Basir, Radiah Abdul Ghani, Muhammad Ibrahim, Khattak, Muhammad Muzaffar Ali Khan, Muhammad Nor Omar, Nor Azwani Mohd Shukri
    Malays J Nutr, 2019;25(3):309-320.
    Introduction: This study aimed to determine the relationship of maternal dietary
    intake with human milk nutritional composition, among Malay mothers during the
    postpartum period of exclusive breastfeeding. Methods: Human milk samples (20-
    30ml) were collected from mothers (n=32) at least once monthly for six months
    postpartum. Macronutrients and fatty acids contents were determined using
    proximate analysis and gas chromatography methods, respectively. Maternal
    dietary intakes were recorded using the multiple-pass diet recall method prior
    to each milk sampling and were analysed using the Nutritionist ProTM software.
    Associations between the milk composition and maternal diet were tested using
    Spearman correlation. Results: The energy content ranged between 49.6-59.2
    kcal/100ml, protein 1.3-1.4 g/100ml, carbohydrate 6.5-9.7 g/100ml and total
    fat 6.5-9.7 g/100ml. The polyunsaturated, monounsaturated, and saturated fatty
    acids concentrations were 10.5-19.1 %, 40.6-43.5 %, and 38.0-49.7 %, respectively.
    During confinement (first month postpartum), total energy and total fat content of
    human milk were the highest whereas total carbohydrate was the lowest, compared
    to the rest of the exclusive breastfeeding period. In contrast, intakes of total calorie
    and total fat were the lowest, whereas protein was the highest during this period.
    However, no associations were detected between human milk nutritional contents
    and maternal dietary intake. Conclusion: In our study population, the composition
    of maternal diet and nutritional content of human milk differed between confinement
    and post-confinement periods. However, the association between maternal diet and
    human milk composition itself warrants further investigation.
  6. Siti Munirah Abdul Basir, Radiah Abdul Ghani, Muhammad Ibrahim, Muhammad Muzaffar Ali Khan Khattak, Muhammad Nor Omar, Nor Azwani Mohd Shukri
    The World Health Organization (WHO) and United Nations Children’s Fund (UNICEF) strongly advocate exclusive breastfeeding for the first six months after birth as the optimal way of feeding infants. Nutritional inadequacy during breastfeeding period may lead to breastfeeding problems such as inadequate milk production which is a common reason to early breastfeeding termination.
    Galactagogue is one of the solutions seek by breastfeeding mothers to overcome this problem. Within the topic of prophetic medicine, scholars discussed the foods consumed by Prophet Muhammad (P.B.U.H) and their health benefits. Among the plants mentioned in Islamic literature are F.carica (figs), O.europea (olive), P.granatum (pomegranate) and N.sativa (habbatussauda). Studies on prophetic foods consumption among lactating mothers is limited in the literature. Thus, the aims of this study to explore on prophetic food consumption, among Malay mothers during
    exclusive breastfeeding period. Ten subjects are interviewed by in-depth semistructured interview guide. Inclusion criteria include Malay mothers aged 18 to 40 years, deliver full term babies and were exclusively breastfeeding. Audio-recorded interviews were transcribed verbatim in Malay and translated into English. Translated transcripts were then analysed thematically with the help of NVivo software. Thematic analysis revealed three themes that represents participants’ knowledge, attitude and practice on prophetic foods consumption. The themes were 1) prophetic diet is related to Prophet Muhammad (P.B.U.H)’s practice on foods and eating manners, 2) perceived benefits and effectiveness of prophetic foods consumption, and 3) Practice of prophetic foods consumption during exclusive breastfeeding period. This study provides an insight to the understanding and
    perception on prophetic foods consumption during exclusive breastfeeding period among breastfeeding mothers. It is acknowledged that prophetic foods, particularly dates may have lactogenic function. Further studies should be carried out to investigate the relationship between prophetic foods consumption and lactogenic activity.
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