Variations in the Measurement of Early-infant Feeding Practices and Effects on Associations in Epidemiological Research
Bibliographic record
Abstract
Rates of exclusive breastfeeding to 6 months of age remain low globally and little progress has been made over the past decade in some countries like Bangladesh. As such, research efforts should continue to focus on modifiable risk factors to promote breastfeeding. To date, such factors have been identified through studies that adopted varied methods for measuring breastfeeding practices. Therefore, in my doctoral thesis, I aimed to compare methods of measuring breastfeeding practices (referred to as metrics), highlighting the implications on population-level surveillance and epidemiological studies. Furthermore, I aimed to estimate the association between mode of delivery – a potentially modifiable factor of public health importance – and breastfeeding using accurate measurement approaches. I used data from the Synbiotics for the Early Prevention of Severe Infections in Infants (SEPSiS) Observational Cohort Study conducted in Dhaka, Bangladesh. Infant feeding in the past 24 hours and 7 days were collected longitudinally during routine visits from baseline (0-4 days of age) to 6 months of age, with an additional since-birth recall at 6-months (metrics derived using different recalls). In the first study, I compared effects of different metrics on estimates of population-level prevalence and individual-level classification of early-infant feeding practices and found that single cross-sectional and long retrospective recall lead to inaccurate estimates compared to longitudinal data. In the second study, I estimated the modifying effect of different metrics on associations between maternal and perinatal characteristics and early-infant feeding practices and found that the effect of the metric was unpredictable and, in some cases, the use of biased metrics attenuated the association. In the third study, I estimated the association between mode of delivery and early-infant feeding practices and found that infants born by C-section were less likely to initiate breastfeeding early compared to those born vaginally, although the mechanism was not distinctively through immediate skin-to-skin contact and there was no evidence of a difference in the duration of exclusive breastfeeding. Overall, these results generate new evidence on methods to ascertain data on early-infant feeding practices and can provide government and non-governmental organizations with evidence to prioritize and fund breastfeeding promotion policies and programmes.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.409 | 0.612 |
| Meta-epidemiology (narrow) | 0.001 | 0.002 |
| Meta-epidemiology (broad) | 0.002 | 0.005 |
| Bibliometrics | 0.005 | 0.013 |
| Science and technology studies | 0.002 | 0.007 |
| Scholarly communication | 0.006 | 0.004 |
| Open science | 0.004 | 0.007 |
| Research integrity | 0.003 | 0.003 |
| Insufficient payload (model declined to judge) | 0.001 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; the direct Gemma label and the distilled Codex classifier agree on what is shown here.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".