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Fulltext Association between Breastfeeding Attitudes and Postpartum Depression among Mothers with Premature Infants during COVID-19 Pandemic

Yahya NFS, Teng NIMF, Shafiee N, Juliana N

Int J Environ Res Public Health, 2021 10 17;18(20).
PMID: 34682652 DOI: 10.3390/ijerph182010915

Breastfeeding is the best form of feeding for premature infants. However, mothers with premature delivery are frequently reported to be depressed, and this has been especially the case during the Coronavirus Disease-2019 (COVID-19) pandemic. We aimed to measure the level of breastfeeding attitude and its association with postpartum depression among mothers with premature infants in the Neonatal Intensive Care Unit (NICU) during the COVID-19 pandemic. A total of 248 mothers with a premature infant were observed in this cross-sectional study from the chosen NICUs of government hospitals in Selangor, Malaysia. The Iowa Infant Feeding Attitude Score (IIFAS) and the Edinburgh Postnatal Depression Scale, along with sociodemographic questionnaires, were used to obtain information on the mothers' attitudes towards breastfeeding and the risk of postpartum depression. A higher percentage of mothers had a positive attitude towards breastfeeding (64.9%), with a mean IIFAS score of 66.30 ± 6.92. Meanwhile, about 27% of mothers with premature infants were reported to have high risk of depressive symptoms. Mothers with a high risk of depression were less likely to have a positive attitude towards breastfeeding (OR 0.37, 95% CI 0.199, 0.675) as compared to mothers with a low risk of depression (p < 0.01). We found that there is an association between the risk of depression and the attitude towards breastfeeding. Early identification of maternal mental health problems should be addressed to ensure the willingness of mothers to continue breastfeeding.
Fulltext Nutrition and physical activity interventions to ameliorate postpartum depression: A scoping review

Yahya NFS, Teng NIMF, Das S, Juliana N

Asia Pac J Clin Nutr, 2021 Dec;30(4):662-674.
PMID: 34967195 DOI: 10.6133/apjcn.202112_30(4).0013

BACKGROUND AND OBJECTIVES: Globally, there is a high prevalence of postpartum depression (17.7%) reported in a recent study among mothers during the postpartum period. It contributes to poor health and well-being among newly delivered women. We reviewed the published effect of nutrition and physical activity interventions on improving and treating postpartum depression.
METHODS AND STUDY DESIGN: The scoping review was performed using Arksey and O'Malley's methodological framework. The systematic search was conducted using Scopus, Pubmed, EBSCOHost and Google Scholar in April 2020, updated in March 2021. Only literature published between January 2010 until February 2021 was searched.
RESULTS: A total of 25 articles were included, of which 23 were randomised controlled trials , and 2 were quasi-experimental studies. Some of studies found improvements in depression (76% out of all studies). On this basis, nutrition or physical activity intervention probably improves postpartum depression. Moreover, the integration of nutrition and physical activity appears to improve depression in the more thorough follow-up of participants . Active involvement of the participant in the interventions was contributory to effectiveness.
CONCLUSIONS: Nutrition and physical activity interventions with appropriate strategy and delivery are promising options for the management of postpartum maternal mental health. More definitive investigation of non-pharmacological interventions to ameliorate depression among postpartum women is warranted.
Prevalence of lactose intolerance and malabsorption among children of two ethnic groups from the urban areas of Malaysia and its relation to calcium intake and bone health status

Makbul IAA, Daud NM, Yahya NFS, Aziz NA

Arch Osteoporos, 2021 Dec 30;17(1):10.
PMID: 34967925 DOI: 10.1007/s11657-021-01053-x

Lactase insufficiency could develop into lactose intolerance (LI) and disrupt the intake of calcium, which is a core nutrient for bone development in children. However, data regarding the prevalence of LI and bone health status (BHS) among Malaysian children are scarcely reported.
PURPOSE: This study aimed to determine the prevalence of LI and lactose malabsorption (LM) in Malay and Chinese children and examine its relationship with calcium intake (CI) and BHS.
METHODS: A total of 400 children participated in this study. The prevalence of lactose tolerance (LT) was assessed using hydrogen breath test, LT test, and visual analogue scales. Assessment of CI was performed using a 24-h dietary recall interview (24-h DR) and food frequency questionnaire (FFQ). Calcaneal broadband ultrasound attenuation (BUA) was measured using a quantitative ultrasonometer.
RESULTS: The prevalence of LI among Chinese children (37%) was significantly higher (p = 0.002) than among Malay children (22.5%). However, 61.5% of Malay and 54.5% of Chinese children were found to have LM. CI of the children fulfilled 30.5% and 33.9% of the Malaysian recommended CI (1300 mg/day) for 24-h DR and FFQ, respectively. The BUA score of Malay children was significantly higher (p 0.05, respectively).
CONCLUSIONS: LI was diagnosed among Malay and Chinese children. However, the higher prevalence of LM is rather worrying as it could develop to LI. The prevalence possibly has been worsened by insufficient CI. Thus, effective approaches to increase CI are highly needed as bone development occurs rapidly at this age and is important for the attainment of the optimum peak bone mass during late adolescence.
Association of calcium intake, lactose intolerance and physical activity with bone health assessed via quantitative ultrasound among young adults of a Malaysian university

Yahya NFS, Daud NM, Makbul IAA, Aziz QASA

Arch Osteoporos, 2021 01 15;16(1):14.
PMID: 33452644 DOI: 10.1007/s11657-020-00874-6

Lactose intolerance has been proposed to cause poor bone health. This study found the prevalence of lactose intolerance was high among Malaysian young adults, but not associated with bone health status, unlike calcium intake. This is the first study that investigated the association of lactose intolerance and bone health status in Malaysia.
PURPOSE: The aims of this study were to determine the prevalence of lactose intolerance, calcium intake and physical activity level and to investigate the association between these variables with bone health status among young adults.
METHODS: This cross-sectional study consisted of 300 Malay, Chinese and Indian students from Universiti Kebangsaan Malaysia with mean age of 22.5 ± 3.2 years. Determination of lactose tolerance status was performed using hydrogen breath test, lactose tolerance test and visual analogue scales. Calcium intake and physical activity level were evaluated using Food Frequency Questionnaire and International Physical Activity Questionnaire, respectively. Bone health status was assessed on calcaneal bone, using quantitative ultrasound.
RESULTS: Lactose intolerance was highly reported among the Malay subjects (72%) followed by Chinese (59%) and Indians (42%). The mean calcium intake was 542.9 ± 365.2 mg/day whilst the mean physical activity was 2757.6 ± 2007.2 MET-min/week. The bone assessment showed that 91% of the subjects had a low risk of developing osteoporosis. Only calcium intake showed a significant association with bone health status (β = 0.006; p = 0.033), whilst no association was shown for lactose intolerance and physical activity level.
CONCLUSIONS: Malaysian young adults showed a high prevalence of lactose intolerance. Calcium intake is associated with increased bone health status. In contrast, lactose intolerance and physical activity level did not directly influence bone health status. Nutrition education promoting adequate calcium intake should be implemented among young adults due to high lactose intolerance prevalence and low calcium intake among subjects.